双能CT静脉期碘图及融合图像浆膜高强化征鉴别T3期与T4a期胃癌  

Serous hyperenhancement sign of iodine map and fusion image in dual-energy CT venous phase to distinguish T3 and T4a stage gastric cancer

作　　者：严映 张梦梅 吕艳娥 杨亚英[1] 熊倩[1] YAN Ying;ZHANG Meng-mei;LYU Yan-e(Department of Medical imaging,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院影像科,昆明650032

出　　处：《放射学实践》2021年第7期894-898,共5页Radiologic Practice

摘　　要：目的:探讨双能CT静脉期碘图及融合图像浆膜高强化征鉴别T3期与T4a期胃癌的诊断效能。方法:回顾性分析本院2017年6月-2019年1月经病理证实为T3期和T4a期胃癌的82例患者术前腹部双能CT扫描的影像资料,观察并比较静脉期碘图和静脉期融合图像浆膜高强化征的出现率。以出现浆膜高强化征为诊断T4a期胃癌的标准,分别计算静脉期碘图和静脉期融合图像诊断T3期与T4a期胃癌的符合率、特异度、敏感度、阳性预测值以及阴性预测值。结果:82例胃癌患者中,T3期27例,T4a期55例。静脉期碘图、静脉期融合图像及联合静脉期碘图、融合图像显示浆膜高强化征诊断T4a期胃癌的符合率、敏感度、特异度、阴性预测值、阳性预测值分别为78.04%(64/82)、81.81%(45/55)、70.37%(19/27)、65.51%(19/29)、84.90%(45/53),74.39%(61/82)、72.72%(40/55)、77.77%(21/27)、58.33%(21/36)、86.95%(40/46),89.02%(73/82)、90.90%(50/55)、85.18%(23/27)、82.14%(23/28)、92.59%(50/54)。静脉期碘图、静脉期融合图像及联合静脉期碘图、融合图像显示浆膜高强化征诊断T4a期胃癌的阳性率分别为81.81%、72.72%、90.90%。两两比较,联合诊断及静脉期碘图的阳性诊断率均高于静脉期融合图像,且差异均具有统计学意义(P<0.05),而静脉期碘图与联合诊断的阳性率差异无统计学意义(P=0.16)。结论:双能CT静脉期碘图显示浆膜高强化征诊断T4a期胃癌较融合图像检出率更高,联合静脉期碘图、融合图像的诊断符合率最高。Objective:To evaluate the diagnostic efficacy of iodine map and fusion image in dual-energy CT venous phase to differentiate T3 and T4 a stage gastric cancer.Methods:The image data of 82 patients with T3 or T4 a stage gastric cancer pathologically confirmed from June 2017 to January 2019 were retrospectively analyzed.The occurrence rate of serous hyperenhancement sign of iodine map and fusion image in venous phase was observed and compared.The serous hyperenhancement sign was used as the diagnostic standard for T4 a stage gastric cancer.The diagnostic efficacy of iodine map and fusion image in venous phase in differentiating T3 and T4 a gastric cancer were measured and compared,including accuracy,specificity,sensitivity,positive and negative predictive value.Results:Among 82 patients,twenty-seven and 55 patients were with T3 and T4 a stage gastric cancer,respectively.The accuracy,sensitivity,specificity,negative and positive predictive value of serous hyperenhancement sign in iodine map,fusion image and combination of iodine map and fusion image in venous phase were 78.04%(64/82),81.81%(45/55),70.37%(19/27),65.51%(19/29),84.90%(45/53);74.39%(61/82),72.72%(40/55),77.77%(21/27),58.33%(21/36),86.95%(40/46);89.02%(73/82),90.90%(50/55),85.18%(23/27),82.14%(23/28),92.59%(50/54),respectively.The positive rate of serous hyperenhancement sign in the diagnosis of T4 a gastric cancer was 81.81%,72.72%and 90.90%in iodine map,fusion image and combination of iodine map and fusion image in venous phase,respectively.The diagnostic efficacy of iodine map,and combination of iodine map and fusion image in venous phase were comparable(P=0.16),that were all significantly higher than the diagnostic efficacy of fusion image(P<0.05).Conclusion:The detection rate of serous hyperenhancement sign of iodine map in dual-energy CT venous phase is higher than that of fusion image in the diagnosis of T4 a gastric cancer.The combination of iodine map and fusion image in venous phase is recommended,which has the highest accuracy rate.

关 键 词：胃肿瘤 浆膜浸润 浆膜高强化征 双能CT 

分 类 号：R814.42[医药卫生—影像医学与核医学] R735.2[医药卫生—放射医学]