IQon能谱CT多参数定量评估肺癌淋巴结转移的诊断效能  

Diagnostic efficiency of multi-parameter quantitative evaluation of IQon energy spectrum CT in lymph node metastasis of lung cancer

作　　者：何家伟[1] 程庆红[1] 祝丁丁[1] 盛茂[1] HE Jiawei;CHENG Qinghong;ZHU Dingding;SHENG Mao(Department of Imaging,The Second People’s Hospital of Hefei,Hefei Hospital Affiliated to Anhui Medical University,Hefei 230011,Ahhui Province,China)

机构地区：[1]合肥市第二人民医院(安徽医科大学附属合肥医院)影像中心,安徽合肥230011

出　　处：《肿瘤影像学》2022年第4期367-371,共5页Oncoradiology

基　　金：中国红十字2021医学赋能—领航菁英科研项目基金(XM_HR_YXFN_2021_05_19)。

摘　　要：目的:分析IQon能谱CT(IQon-spectral CT)多参数定量评估肺癌淋巴结转移的诊断效能。方法:选取2021年1—6月在合肥市第二人民医院就诊且经病理学检查证实为非小细胞肺癌的86例患者为研究对象,患者均接受IQon能谱CT动脉期及静脉期增强扫描,并行肺癌切除及纵隔淋巴结清扫术,共获得淋巴结143枚,其中转移93枚,未转移50枚。比较肺癌原发病灶与转移、未转移淋巴结的动脉期及静脉期能谱参数,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析能谱参数诊断肺癌淋巴结转移的临床价值。结果:转移淋巴结与肺癌原发病灶动、静脉期各能谱参数比较,差异均无统计学意义(P>0.05)。未转移淋巴结与肺癌原发病灶动、静脉期碘浓度(iodine concentration,IC)值,标准化碘浓度(normalized iodine concentration,NIC)值,能谱曲线斜率(the slope of the spectral Hounsfeld unit curve,λ_(H)),有效原子序数(effective atomic number,Eff-Z)参数比较,差异均有统计学意义(P<0.05)。转移组与未转移组淋巴结动、静脉期IC值,NIC值,λ_(H),Eff-Z参数比较,差异均有统计学意义(P<0.05)。动脉期组NIC值的曲线下面积(area under curve,AUC)为0.823,诊断淋巴结转移的灵敏度和特异度分别为65.48%、92.72%;静脉期NIC值的AUC为0.882,诊断淋巴结转移的灵敏度和特异度分别为84.72%、82.87%。静脉期NIC值诊断肺癌淋巴结转移的临床价值更高。结论:IQon能谱CT多参数定量对评估肺癌淋巴结转移具有一定的临床应用价值,其中以NIC参数诊断效能最高,可为肺癌患者术前淋巴结鉴别诊断及确定治疗方案提供重要依据。Objective:To analyze the diagnostic efficiency of IQon energy-spectral CT for quantitative multiparametric assessment of lymph node metastasis in lung cancer.Methods:A total of 86 patients treated in The Second People’s Hospital of Hefei from January to June 2021 and pathologically confirmed as non-small cell lung cancer were selected as the research objects.All of patients underwent IQon-spectral CT arterial and venous phase enhanced scans,and lung cancer resection and mediastinal lymph node dissection were performed.A total of 143 lymph nodes were obtained,of which 93 were metastasized and 50 were not.The energy spectrum parameters of primary lung cancer and metastasis,non-metastasis lymph node in arterial and venous phase were compared,and receiver operating characteristic(ROC)curves were used to analyze the clinical value of the energy spectrum parameters in diagnosis of lung cancer lymph node metastasis.Results:There was no significant difference in energy spectrum parameters between metastatic lymph nodes and primary lung cancer lesions in the arterial and venous phases(P>0.05).There was a statistically significant difference in the iodine concentration(IC)value,normalized iodine concentration(NIC)value,the slope of the spectral Hounsfeld unit curve(λ_(H))and effective atomic number(Eff-Z)parameters between the non-metastatic lymph nodes and the primary lung cancer lesions in the arterial and venous phases(P<0.05).There was a statistically significant difference in the lymph node IC value,NIC value,λ_(H)and Eff-Z parameters between the metastatic group and the non-metastatic group in the arterial and venous phase(P<0.05).Area under curve(AUC)of the NIC value in the arterial phase group was 0.823,and the sensitivity and specificity for diagnosing lymph node metastasis were 65.48%and 92.72%,respectively;the AUC of the NIC value in venous phase was 0.882,the sensitivity and specificity for diagnosing lymph node metastasis were 84.72%and 82.87%,respectively.The venous phase NIC value has the highest clinica

关 键 词：IQon能谱CT 多参数定量 肺癌 淋巴结转移 诊断效能 

分 类 号：R734.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]