CT能谱成像在胃癌与高度侵袭危险性胃间质瘤鉴别诊断中的应用  

Application of Spectral CT in Differential Diagnosis of the Gastric Cancer and the High-Risk Gastric Stromal Tumors

作　　者：王夏婉 高剑波[1] 柴亚如 陈岩[1] 

机构地区：[1]郑州大学第一附属医院放射科,450052

出　　处：《临床放射学杂志》2017年第6期834-837,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:81271573)

摘　　要：目的探讨CT能谱成像在胃癌与高度侵袭危险性胃间质瘤鉴别诊断中的应用价值。方法回顾性分析经手术病理证实并行CT能谱成像双期增强扫描的30例胃癌及24例高度侵袭危险性胃间质瘤患者的影像资料,通过GSI Viewer分析软件获得病灶能谱曲线,分别计算40~70、70~140、40~140 ke V各能量区间的能谱曲线斜率。同时测量病灶的碘浓度(IC)、水浓度(WC),并计算标准化后的碘浓度(NIC)(病灶碘浓度与同层腹主动脉碘浓度的比值)。结果采用独立样本t检验进行统计学分析,比较两组间的能谱参数差异。结果静脉期,胃癌组的IC(23.78±6.85)(100μg/mL)、NIC(0.54±0.15)均大于相应期相高度侵袭危险性胃间质瘤组(16.87±2.67)(100μg/m L)、(0.34±0.04)(P<0.05),两组的WC差别无统计学意义(P>0.05);静脉期胃癌组在40~70、70~140、40~140 ke V各能量区间的能谱曲线斜率(4.64±1.28、0.68±0.21、1.87±0.53)均大于相应期相胃间质瘤组(3.35±0.52、0.48±0.11、1.33±0.20)(P<0.05)。动脉期胃癌组与高度侵袭危险性胃间质瘤组的IC、NIC、WC及各能量区间的能谱曲线斜率差异均无统计学意义(P>0.05)。结论胃癌和高度侵袭危险性胃间质瘤具有不同的能谱成像参数,可以借助能谱参数对二者进行鉴别诊断。Objective To evaluate the significance of the application of gemstone spectral imaging（ GSI） in the differential diagnosis of the gastric cancer and the high-risk gastric stromal tumors（ GST）. Methods Dual-phase enhanced CT scans by GSI mode were analyzed retrospectively on 30 gastric cancer patients and 24 high-risk GST patients that were confirmed by pathology. The spectral curves were obtained with GSI Viewer software,and calculated the slopes for spectral curve in the 40-70,70-140 and 40-140 keV energy ranges respectively. Iodine concentration（ IC）,water concentration（ WC） and normalized iodine concentration（ NIC） of tumors were also obtained. Data was analyzed statistically by independent t test. Results During the venous phase,the IC（ 23. 78 ± 6. 85）（ 100μg/mL） and NIC（ 0. 54 ± 0. 15） of gastric cancer were higher than those of the high-risk GST（ 16. 87 ± 2. 67）（ 100μg/mL） and（ 0. 34 ± 0. 04）（ P〈0. 05）. The slope of the gastric cancer in the 40-70,70-140 and 40-140 ke V energy ranges（ 4. 64 ± 1. 28,0. 68 ± 0. 21 and 1. 87 ±0. 53） were higher than those of the high-risk GST（ 3. 35 ± 0. 52,0. 48 ± 0. 11 and 1. 33 ± 0. 20）（ P〈0. 05）. There was no significant difference in the WC between the two groups（ P〈0. 05）. During the arterial phase,there were no significant differences in the IC、NIC、WC and the slope in all energy ranges between the two groups（ P〈0. 05）. Conclusion Spectral CT parameters are helpful in differential diagnosis of the gastric cancer and the high-risk GST.

关 键 词：体层摄影术 X线计算机 能谱成像 胃癌 胃间质瘤 

分 类 号：R730.44[医药卫生—肿瘤] R735.2[医药卫生—临床医学]