术前CT评估腹膜假黏液瘤患者腹膜癌指数与可切除相关性分析  

Correlation Between Preoperative CT Peritoneal Cancer Index and Resectability in Patients with Pseudomyxoma Peritoneal

作　　者：李洋 于海涛[1] 卫宏江[1] 许洪斌[2] 陈峰[2] 张晓锦[1] LI Yang;YU Haitao;WEI Hongjiang(Department of Radiology,Peking University Aerospace School of Clinical Medicine,Beijing 100049,P.R.China)

机构地区：[1]航天中心医院放射科,北京100049 [2]航天中心医院黏液瘤科,北京100049

出　　处：《临床放射学杂志》2019年第10期1881-1885,共5页Journal of Clinical Radiology

摘　　要：目的分析腹膜假黏液瘤(PMP)患者术前CT腹膜癌指数(PCI)与术中PCI的相关性,分析CT-PCI≥20是否代表PMP不可切除。方法回顾性分析71例PMP患者的术前CT-PCI评分,与术中PCI评分进行对照,计算Spersman相关系数。进行阅片者间CT-PCI分析,计算Spersman相关系数。以PCI≥20为截点,计算CT-PCI的敏感性、特异性及准确性。结果 71例患者平均术中PCI为26.5±10.6,平均CT-PCI为26.0±11.2。两位阅片者CT-PCI与术中PCI的相关系数分别为0.83和0.79,平均CT-PCI与术中PCI的相关系数为0.84,阅片者间CT-PCI的相关系数为0.85。以PCI≥20为截点,平均CT-PCI的敏感性为73.3%,特异性为98.2%,准确性为93.0%。在CT-PCI≥20的患者中,13例(46.4%)患者仍然完成了完全细胞减灭术。结论 CT-PCI与术中PCI具有较好的相关性,且阅片者间CT-PCI相关性较高。虽然术前CT评估PCI≥20较为准确,但是以CT-PCI≥20作为是否可切除的截点存在一定的问题。需结合CT图像小网膜囊及小肠区CT-PCI综合评估,从而为临床提供指导。Objective To analyze the correlation between preoperative CT peritoneal cancer index(PCI) and intraoperative PCI in patients with pseudomyxoma peritoneal(PMP),and to analyze whether CT-PCI≥20 representing unresectabledisease. Methods Two radiologists retrospectively reviewed images of 71 patients with PMP to calculate CT-PCI scores.Correlation between CT-PCI and surgical PCIw as assessed using spearman correlation coefficient. Preoperative assessment of a PCI cutoff of 20 on imaging was compared with actual surgical PCI using sensitivity,specificity,and accuracy. Results71 patients had a mean surgical score of 26. 5 ± 10. 6 and mean CT-PCI of 26. 0 ± 11. 2. Correlation between individual radiologists and surgical PCI was 0. 83 and 0. 79,respectively. Correlation between Mean CT-PCI and surgical PCI was 0. 84.CT-PCI had a sensitivity of 73. 3%,a specificity of 98. 2%,and accuracy of 93. 0%. In patients with a CT-PCI ≥20,13/28(46. 4%)still achieved adequate cytoreduction. Conclusion CT-PCI correlated well with surgical PCI,and the CT-PCI correlation between the two radiologists was good. Although preoperative assessment of PCI≥20 was reasonably accurate,using this cutoff to assess resectability was problematic. The CT-PCI of the small omental sac and small intestine area had to be assessed for comprehensive evaluation,thus providing guidance for the clinic.

关 键 词：腹膜假黏液瘤 CT 腹膜癌指数 完全细胞减灭分数 

分 类 号：R54[医药卫生—心血管疾病]