碘浓度及Overlay值对结直肠癌肿大淋巴结的影像诊断价值比较  

Comparsion of Iodine content and Overlay value for imaging diagnostic value of enlarged lymph node for colorectal cancer

作　　者：杨雪君[1] 邓亚敏[1] 赵卫[1] 郑凌琳 者光玲 杨亚英[1] 

机构地区：[1]昆明医科大学第一附属医院医学影像科,昆明650032

出　　处：《重庆医学》2016年第34期4808-4810,共3页Chongqing medicine

摘　　要：目的探讨双源CT双能量扫描后碘图中碘浓度及碘图CT值(Overlay值)在结直肠癌转移淋巴结与炎性淋巴结鉴别诊断中的价值。方法收集有完整双源CT双能量扫描资料并经手术病理证实的30例结肠直肠癌,共102枚区域淋巴结。将双能量动脉期增强扫描图像调入双能后处理软件"Liver VNC",分别测量结直肠癌转移淋巴结及反应性增生淋巴结实性部分的动脉期强化CT值、碘浓度及Overlay值。结果在102枚淋巴结中,结直肠癌转移性淋巴结53枚,反应性增生49枚。结直肠癌转移淋巴结与反应性增生淋巴结动脉期强化CT值分别为(31.32±12.31)、(36.30±15.16)HU,动脉期碘浓度分别为(1.67±0.78)、(3.21±0.89)mg/mL,Overlay值分别为(35.46±11.62)、(58.25±18.25)HU。结直肠癌转移淋巴结与反应性增生淋巴结之间强化CT值、碘浓度及Overlay值差异均具有统计学意义(t=23.674、9.210、7.454,均P=0.000)。利用强化CT值诊断转移淋巴结时,敏感度为57.1%,特异度为60.4%,AUC(ROC曲线下面积)为0.602;碘浓度诊断转移淋巴结时,敏感度为85.7%,特异度为86.8%,AUC为0.971;利用Overlay值诊断转移淋巴结时,敏感度为84.6%,特异度为69.8%,AUC为0.862。结论动脉期碘浓度及Overlay值对鉴别结直肠癌区域淋巴是否转移均有一定的意义,且碘含量的诊断价值最高。Objective To explore the value of Iodine content and Overlay value in dual-energy CT in differential diagnosis of the inflammatory and metastatic lymph nodes in colorectal cancer. Methods In 30 patients with pathologically confirmed with a to- tal of 102 lymph nodes enlargement with eolorectal cancer which are using dual energy scan;the Iodine content and Overlay value of inflammatory and metastatic lymph nodes were measured. Results In the 102 lymph nodes, the metastatic lymph nodes in Colorectal cancer is 53, reactive hyperplasia of lymph node is 49. Colorectal cancer metastasis and lymph node hyperplasia of reactivity lymph node arterial contrast enhanced CT value were（31.32±12.31）HU, （36.30±15.16）HU;arterial iodine content were（1.67± 0. 78）mg/mL,（3.21±0.89）mg/mL;Overlay values were （35.46±11.62） HU, （58.25±18.25） HU. Colorectal cancer metastasis and lymph node reactive hyperplasia of lymph nodes between enhanced CT value,iodine content and Overlay differences were statistically significant（t= 9. 210,P=0. 000;t=7. 454,P=0. 000）. The sensitivity of 57.1% ,85.7% ,84.6% ;the specificity of 60.4%, 86.8% ,69.8% ;the area under the ROC curve were 0. 602,0. 971,0. 862. Conclusion Iodine content and Overlay value of inflammatory and metastatic lymph nodes has a certain significance in differential diagnosis. Iodine content is superior to Overlay value and enhanced CT value for differential diagnosis of the two kinds of lymph node.

关 键 词：结直肠肿瘤 淋巴结 淋巴转移 反应性增生淋巴结 碘含量 Overlay值 双能量CT 

分 类 号：R735.3[医药卫生—肿瘤] R730.44[医药卫生—临床医学]