双源CT能谱参数对Lauren弥漫型与肠型胃癌的鉴别诊断价值  

Value of dual-source CT energy spectrum parameters in differential diagnosis of lauren diffuse type and intestinal type of gastric cancer

作　　者：吉玉刚 陈光强[3] 范国华[3] 温竞 卢定友 吴旭东 JI Yu-gang;CHEN Guang-qiang;FAN Guo-hua(Department of Radiology,Yancheng First People's Hospital,Jiangsu 224006,China)

机构地区：[1]盐城市第一人民医院CT室,江苏224006 [2]盐城市第一人民医院消化科,江苏224006 [3]苏州大学附属第二医院影像科,江苏215004 [4]江苏医药卫生职业学院影像学院,江苏224006

出　　处：《放射学实践》2020年第9期1122-1126,共5页Radiologic Practice

摘　　要：目的:探讨双源CT能谱定量参数对Lauren弥漫型与肠型胃癌的鉴别诊断价值。方法:前瞻性搜集胃镜提示胃癌、术前行双源CT能谱增强扫描、术后病理确诊为Lauren弥漫型或肠型胃癌的患者61例,另搜集胃镜及能谱CT增强扫描均正常的25例患者为对照组。测量动、静脉期标准化碘浓度(ANIC、VNIC)及动、静脉期能谱曲线40~70 keV区间的斜率(λa、λv),采用单因素方差分析比较ANIC、VNIC、λa、λv在弥漫型胃癌组、肠型胃癌组及对照组间的差异,并绘制以上参数鉴别诊断弥漫型与肠型胃癌的受试者工作特征(ROC)曲线。结果:弥漫型胃癌组、肠型胃癌组、对照组的ANIC值分别为(21.4±2.22)%、(20.22±1.64)%、(18.96±1.76)%,VNIC值分别为(58.31±3.49)%、(55.40±3.70)%、(52.71±3.73)%,λa分别为-3.15±0.23、-3.01±0.22、-2.65±0.20,λv分别为-3.62±0.23、-3.37±0.22、-2.85±0.20,以上参数三组间差异均有统计学意义(P<0.05);能谱参数ANIC、VNIC、λa、λv鉴别诊断弥漫型与肠型胃癌的ROC曲线下面积(AUC)分别为0.677、0.722、0.674、0.765;联合VNIC和λv鉴别诊断弥漫型与肠型胃癌的AUC为0.821,敏感度为0.750,特异度为0.758。结论:双源CT能谱参数在鉴别诊断Lauren弥漫型与肠型胃癌方面有一定价值。Objective:To explore the value of dual-source CT energy spectrum quantitative parameters in differential diagnosis of Lauren diffuse type and intestinal type of gastric cancer.Methods:From September 2018 to July 2019,61 cases of gastric cancer were prospectively enrolled in the Yancheng First People's Hospital,which were diagnosed with gastric cancer by gastroscopy,underwent dual-source CT enhanced energy spectrum scanning before surgery,and had postoperative pathology of Lauren diffuse type or intestinal type of gastric cancer.Besides,25 cases with normal enhanced CT scanning by gastroscopy and energy spectrum were collected as the control group.The normalized iodine concentration(ANIC,VNIC)and the slope of the energy spectrum curve from 40keV to 70keV(λa、λv)in the arterial and venous phase were measured as the statistical parameters.One-way ANOVA was used to compare the differences among the diffuse gastric cancer,intestinal type gastric cancer and control groups.The receiver operating characteristic curve(ROC)was drawn to differentiate diffuse gastric cancer from intestinal gastric cancer.Results:ANIC(21.4±2.22%,20.22±1.64%,18.96±1.76%),VNIC(58.31±3.49%,55.40±3.70%,52.71±3.73%),λa(-3.15±0.23,-3.01±0.22,-2.65±0.20),λv(-3.62±0.23,-3.37±0.22,-2.85±0.20)were significantly different among tthree groups.The areas under ROC curve of ANIC,VNIC,λa andλv were 0.677,0.722,0.674 and 0.765,respectively.Combined with VNIC andλv,AUC,sensitivity and specificity were 0.821,0.750,and 0.758,respectively.Conclusion:There are certain value in distinguishing diffuse gastric cancer from intestinal gastric cancer for dual-source CT energy spectrum parameters.

关 键 词：胃肿瘤 弥漫型胃癌 肠型胃癌 体层摄影术 X线计算机 双源CT 标准化碘浓度 能谱曲线 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]