能谱CT增强动、静脉标准化碘浓度在结肠癌转移性淋巴结鉴别中的价值  

Value of Standardized Iodine Concentration in Artery and Vein of Enhanced CT in Differential Diagnosis of Metastatic Lymph Nodes in Colon Cancer

作　　者：董修明[1] 张为 马东东[1] 唐莉[1] 章辉庆[1] 邱晓晖[1] DONG Xiuming;ZHANG Wei;MA Dongdong;TANG Li;ZHANG Huiqing;QIU Xiaohui(Image Center,Bozhou People’s Hospital,Bozhou Anhui 236800,China;Image Center,Lu’an Hospital of Anhui Medical University,Lu’an Anhui 237006,China)

机构地区：[1]亳州市人民医院影像中心,安徽亳州236800 [2]安徽医科大学附属六安医院影像中心,安徽六安237006

出　　处：《中国医疗设备》2021年第11期94-97,共4页China Medical Devices

摘　　要：目的探讨能谱CT增强中动、静脉标准化碘浓度在结肠癌转移性淋巴结鉴别中价值。方法34例结肠癌患者均行全腹部动、静脉标准化碘浓度增强CT扫描,观察原发性病灶、反应性增生淋巴结、转移性淋巴结在碘含量值和CT能谱曲线斜率的差异,分析能谱CT增强中动、静脉标准化碘浓度参数在鉴别转移性淋巴结和反应性增生淋巴结中的准确率、敏感性、特异性。结果34例结肠癌患者术中探查共发现淋巴结504枚,其中转移性淋巴结78枚,反应性增生淋巴结426枚。反应性增生淋巴结、原发性病灶、转移性淋巴结的平均CT能谱曲线斜率依次提升(P<0.05),而它们的平均碘含量值最高依次降低(P<0.05)。碘含量值联合CT能谱曲线斜率值在鉴别转移性淋巴结和反应性增生淋巴结中的准确率(86.98%)、敏感性(87.21%)、特异性(89.83%)均高于单纯碘含量值、单纯CT能谱曲线斜率值的准确率(73.48%、74.63%)、敏感性(73.09%、73.54%)、特异性(70.18%、71.35%)(P<0.05)。结论碘含量值联合CT能谱曲线斜率值在结肠癌转移性淋巴结与反应性增生淋巴结鉴别中具有较高的临床价值。Objective To evaluate the value of estandardized iodine concentration in artery and vein of enhanced CT in differential diagnosis of metastatic lymph nodes in colon cancer.Methods All 34 colon cancer patients underwent full abdominal artery and vein standardized iodine concentration-enhanced CT scan.The differences of iodine content and the slope of CT energy spectrum curve among primary lesions,reactive proliferative lymph nodes and metastatic lymph nodes were observed.And the arterial and venous standardized iodine concentration parameters in the energy spectrum CT enhancement to distinguish metastatic lymph nodes and reactive hyperplasia accuracy,sensitivity,and specificity in lymph nodes were analyzed.Results A total of 504 lymph nodes were found during intraoperative exploration in 34 patients with colon cancer,including 78 metastatic lymph nodes and 426 reactive hyperplastic lymph nodes.The slope of the average CT energy spectrum curves of reactive hyperplastic lymph nodes,primary lesion and metastatic lymph nodes increased sequentially(P<0.05),while their average iodine content values decreased sequentially(P<0.05).The accuracy(86.98%),sensitivity(87.21%)and specificity(89.83%)of iodine content combined with the slope value of CT energy spectrum curve were higher than those of iodine content alone and slope value of CT energy spectrum curve(73.48%,74.63%),sensitivity(73.09%,73.54%)and specificity(70.18%,71.35%)respectively(P<0.05).Conclusion The value of iodine content combined with with CT energy spectrum curve slope value has high clinical value in differentiating metastatic lymph nodes from reactive hyperplasia lymph nodes of colon cancer.

关 键 词：增强体层摄影术 标准化碘浓度 结肠癌 淋巴结 

分 类 号：R739.91[医药卫生—肿瘤] R730.42[医药卫生—临床医学]