CT能谱成像对胃癌诊断价值的初步探讨  

Preliminary study on the value of spectral CT imaging in the diagnosis of the gastric tumor

作　　者：王鑫毅 徐锦媚 白雪莲 周诚[2] Wang Xinyi;Xu Jinmei;Bai Xuelian;Zhou Cheng(China Meitan General Hospital,Beijing 100028,China;Beijing Hosptial,Beijing 100005,China)

机构地区：[1]煤炭总医院,北京100028 [2]北京医院,北京100005

出　　处：《现代肿瘤医学》2020年第13期2295-2299,共5页Journal of Modern Oncology

摘　　要：目的:探讨CT能谱扫描对胃癌诊断的价值。方法:对40例胃腺癌患者行CT能谱增强扫描。在能谱单能量图像上测量和计算不同能量水平下病灶和正常胃壁的CT值、标准差、碘水浓度、病灶-胃壁的对比噪声比(contrast-to-noise ratio,CNR)、病灶能谱曲线斜率和标准化碘(水)浓度,对正常胃壁组和腺癌组间数据进行检验,对双期NIC行ROC工作曲线分析。结果:胃癌双期的最佳单能量水平以60 keV为中心上下浮动,双期最佳的CNR分别为4.13±2.75、6.81±5.10。两组在双期不同能量水平下的CT值和不同能量区间下的曲线斜率有统计学差异(P<0.05)。胃癌组和胃壁组双期标准化碘浓度有统计学意义(P<0.05),动脉期胃癌NIC诊断效能灵敏度和特异度为65%和70%,门脉期NIC诊断效能灵敏度和特异度为70%和65%。结论:CT能谱的多项参数有助于增加对胃癌的诊断信心。Objective:To investigate the value of enhanced spectral CT imaging in the diagnosis of gastric tumor.Methods:Forty patients with gastric tumor underwent enhanced spectral CT imaging.The different CT values and standard deviation and lesion-to-liver contrast-to-noise ratio(CNR)at different energy levels,slopes of spectral HU curves,NIC of the lesions and the normal gastric walls were measured and calculated.Data were analyzed statistically by paired-samples t test.The NIC under arterial phase and and portal vein phase were evaluated using ROC curve analysis.Results:The optimal monochromatic energy level of gastric groups was around 60 keV floating up and down,and corresponding dual phase CNR were 4.13±2.75,6.81±5.10,respectively.The lesion group and the normal gastric wall group had descending spectral HU curves.There were significant differences in slopes and CT values between two groups in the two phase(P<0.05).There were significant differences in NIC between two groups in the two phase(P<0.05).During AP the NIC's sensitivity and specificity were 65%and 70%,while during PVP the NIC's sensitivity and specificity were 70%and 65%.Conclusion:Enhanced spectral CT imaging with multiple parameters may be helpful in diagnosis of gastric tumor.

关 键 词：能谱CT 胃癌 对比噪声比 

分 类 号：R735.2[医药卫生—肿瘤]