双能量CT在晚期非小细胞肺癌放化疗近期疗效评估中的价值  

The role of dual-energy CT in the short-term efficacy evaluation of radiochemotherapy for advanced non-small cell lung cancer

作　　者：侯振国[1] 李永才[1] 高凤霄[1] 鲁北[1] 张孟增[1] 孟令雷 赵欣 HOU Zhenguo;LI Yongcai;GAO Fengxiao;LU Bei;ZHANG Mengzeng;MENG Linglei;ZHAO Xin(Department of Radiology,the People's Hospital of Xingtai,Xingtai,Hebei Province 054031,China)

机构地区：[1]邢台市人民医院影像科,河北邢台054031

出　　处：《实用放射学杂志》2022年第1期38-41,共4页Journal of Practical Radiology

摘　　要：目的 探讨双能量CT(DECT)在评估晚期非小细胞肺癌(NSCLC)放化疗近期疗效评估中的价值.方法 27例晚期NSCLC患者,在接受放化疗前后1周内行DECT扫描,测得48枚实性病灶治疗前后最大径、CT值、碘含量(IU),并比较其治疗前后的差异;利用Pearson相关分析对治疗前后病灶CT值变化率与IU变化率之间的相关性进行分析;依据Choi标准,以IU变化率替代CT值变化率,采用Kappa一致性检验和McNemar检验分别评价IU标准的临床获益率与Choi标准的临床获益率的一致性和差异性.结果 病灶最大径及CT值较治疗前无明显变化(P>0.05),而治疗后IU较前明显减小(P<0.05).治疗前后病灶CT值变化率分别与IU变化率相关性较好(r=0.921,P=0.003).IU标准的临床获益率与Choi标准的临床获益率一致性中等(Kappa=0.695,P=0.000),二者无显著统计学差异(χ^(2)=3.133,P=0.372).结论 IU能较早反映晚期NSCLC对放化疗的应答,与最大径相结合可作为晚期NSCLC放化疗早期疗效评估的一种有效方法.Objective To investigate the value of dual-energy CT(DECT)in evaluating of the short-term efficacy for advanced non-small cell lung cancer(NSCLC)radiochemotherapy.Methods 27 patients with anvanced NSCLC who received DECT 1 week before and after radiochemotherapy were included in the study.The longest diameter,CT value and the iodine-uptake(IU)were analyzed in amount of 48 measurable lesions.Correlation between the rate of change of CT value and IU were analyzed by Pearson correlation analysis.The change rate of CT value was replaced by rate of IU change according to Choi criteria.Clinical benefits which were based on the IU criteria and Choi criteria were evaluated by Kappa consistency test and McNemar test respectively.Results The IU decreased significantly(P>0.05),while longest diameter and CT value showed no difference(P>0.05)after radiochemotherapy.There was correlation between the rate of change of CT value and IU(r=0.921,P=0.003).The clinical benefit of IU criteria was moderately consistent with the clinical benefit of Choi criteria(Kappa=0.695,P=0.000)with no significant statistical difference(X^(2)=3.133,P=0.372).Conclusion The IU measured by DECT is more sensitive to evaluate the early response of advanced NSCLC treated with radiochemotherapy,and combined with the longest diameter can be an effective method for evaluating the short-term efficacy of radiochemotherapy for advanced NSCLC.

关 键 词：双能量CT 放化疗 非小细胞肺癌 碘含量 

分 类 号：R814.42[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]