能谱CT扫描CT值、IC值在胃腺癌淋巴结定性评估中的临床应用  

Clinical application of CT value and IC value of spectral CT scan in qualitative assessment of lymph nodes in gastric adenocarcinoma

作　　者：李祖银 朱迪 夏春华[1] LI Zuyin;ZHU Di;XIA Chunhua(Department of Radiology,the First People’s Hospital of Hefei,Anhui Province,Hefei 230061,China)

机构地区：[1]合肥市第一人民医院放射科,安徽合肥230061

出　　处：《中国医药导报》2021年第4期147-150,183,共5页China Medical Herald

摘　　要：目的探究能谱CT扫描中动、静脉期CT值、碘浓度(IC)值在胃腺癌淋巴结定性评估上的应用价值。方法将合肥市第一人民医院于2016年2月—2020年7月收治的85例胃腺癌患者作为研究对象,所有患者均行常规CT和能谱CT扫描检查。比较转移性淋巴结、非转移性淋巴结的动、静脉期CT值和IC值,同时比较不同分化程度转移性淋巴结的动、静脉期CT值和IC值。绘制能谱CT定量参数在鉴别诊断胃腺癌淋巴结转移上的受试者操作特征(ROC)曲线,并对其诊断效能进行分析。结果转移性淋巴结的动、静脉期CT值和IC值均明显高于非转移性淋巴结的CT、IC值,差异均有统计学意义(均P<0.05)。转移性淋巴结中,低分化腺癌的动、静脉期CT值以及动、静脉期IC值均明显低于中、高分化腺癌的CT、IC值,差异均有统计学意义(均P<0.05)。动脉期CT值、静脉期CT值、动脉期IC值、静脉期IC值在诊断胃腺癌淋巴结转移上的曲线下面积(AUC)分别为0.803、0.712、0.849和0.784,在判断胃腺癌淋巴结转移上均具有较高准确性。结论能谱CT扫描中动、静脉期CT、IC值在术前评估胃腺癌患者淋巴结性质上具有重要价值,可作为评估胃腺癌患者病情、治疗效果及预后的量化指标应用于临床。Objective To explore the application value of CT value and iodine concentration(IC)value in the arterial and venous phase in the spectral CT scan in the qualitative assessment of the lymph nodes in gastric adenocarcinoma.Methods A total of 85 patients with gastric adenocarcinoma admitted to the First People’s Hospital of Hefei,from February 2016 to July 2020 were selected as the research objects.All patients underwent conventional CT scan and spectral CT scan.The CT values and IC values of the arterial and venous phases of metastatic lymph nodes and non-metastatic lymph nodes were compared,and the CT values and IC values of the arterial and venous phases of metastatic lymph nodes of different degrees of differentiation were compared.The receiver operating characteristic(ROC)curve of the quantitative parameters of spectral CT in the differential diagnosis of gastric adenocarcinoma lymph node metastasis was drawed,and its diagnostic efficiency was analyzed.Results The CT values and IC values of arterial and venous phase of metastatic lymph nodes were significantly higher than those of non-metastatic lymph nodes,the differences were statistically significant(all P<0.05).In metastatic lymph nodes,the CT values and IC values of arterial and venous phase of poorly differentiated adenocarcinoma were significantly lower than those of moderately and highly differentiated adenocarcinoma,the differences were statistically significant(all P<0.05).The area under the curve(AUC)of the arterial phase CT value,venous phase CT value,arterial phase IC value,and venous phase IC value in the diagnosis of gastric adenocarcinoma lymph node metastasis are 0.803,0.712,0.849 and 0.784,respectively,they had high accuracy in judging lymph node metastasis of gastric adenocarcinoma.Conclusion The CT value and IC value of arterial and venous phase in spectral CT scan have important value in preoperative evaluation of lymph node properties of patients with gastric adenocarcinoma,which can be used as quantitative indicators to evaluate the con

关 键 词：胃腺癌 转移性淋巴结 能谱CT扫描 CT值 碘浓度值 

分 类 号：R735.2[医药卫生—肿瘤]