能谱CT多参数成像在不同分化胃癌分期中的应用价值  

The application value of gemstone spectral imaging for stages of different differentiated gastric cancer

作　　者：郑玉飞[1] 朱丽丽[1] 陈苏杰 徐辉[2] 王卓群[1] Zheng Yufei;Zhu Lili;Chen Sujie;Xu Hui;Wang Zhuoqun(Department of Imaging,Jurong People＇s Hospital,Jiangsu 212400,China)

机构地区：[1]江苏省句容市人民医院影像科,212400 [2]南京医科大学附属南京医院放射科

出　　处：《实用医学影像杂志》2018年第6期475-477,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨能谱CT在胃腺癌分化及分期评估中的诊断价值。方法分析50例经胃镜病理证实的胃腺癌患者的能谱CT影像资料,以手术及病理为对照,分析能谱CT在胃腺癌分化及T分期诊断中的价值。结果 50例胃癌能谱CT的T分期总体准确率为82%,其中对T1、T2、T3、T4期判断的正确率分别为83%,71%,80%,92%。高中分化腺癌动脉期、静脉期碘值分别为10.3±3.4、18.3±2.6,低分化腺癌动脉期、静脉期碘值分别为13.5±4.1、24.7±2.6,高中分化腺癌与低分化腺癌的动脉期、静脉期碘值差异有统计学意义。高中分化腺癌动脉期、静脉期标准化碘值分别为0.12±0.11、0.45±0.13,低分化腺癌动脉期、静脉期标准化碘值分别为0.19±0.12、0.57±0.20,高中分化腺癌与低分化腺癌的动脉期、静脉期标准化碘值差异有统计学意义。结论能谱CT可以利用最佳单能量图像及碘值等参数来评估胃癌的分化程度及术前T分期,为胃癌的临床诊断及治疗方案的选择提供帮助。Objective To explore the application value of gemstone spectral imaging （GSI） for preoperative pathological types and stages of gastric cancer. Methods The GSI imaging of 50 patients with gastric carcinoma confirmed by gastroscopy and pathology were analyzed. The value of GSI in the diagnosis of gastric adenocarcinoma differentiation and T staging was analyzed based on pathology. Results The total accuracy rate of T staging in 50 cases of gastric cancer was 82%, and the correct rate for T1, T2,T3 and T4 were 83%, 71%, 80%, 92%, respective- ly. Iodine number in arterial phase and venous phase of high and moderate differentiated adenocarcinoma were 10.3±3.4, 18.3±2.6, while poorly differentiated adenocarcinoma were 13.5±4.1, 24.7±2.6（P〈0.05）. Standardized iodine num- ber in arterial phase and venous phase of high and moderate differentiated adenocarcinoma were 0.12±0.11,0.45± 0.13, while poorly differentiated adenocarcinoma were 0.19±0.12, 0.57±0.20（P〈0.05）. Conclusion Spectral CT can assess the degree of tumor differentiation and preoperative T staging using optimal monochromatic energy image and IC,NIC, providing help for the clinical diagnosis and treatment of gastric cancer.

关 键 词：胃肿瘤 体层摄影术 X线计算机 病理学 分子 

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