双能CT的定量参数对直肠癌新辅助治疗疗效的评估价值  

The value of quantitative parameters of dual-energy CT in the evaluation of efficacy of neoadjuvant therapy for rectal cancer

作　　者：方著 李杭[2] 袁艺 张凤 周芸慧 蒲红[2] FANG Zhu;LI Hang;YUAN Yi;ZHANG Feng;ZHOU Yun-hui;PU Hong(North Sichuan Medical College,Nanchong 637000,China;Department of Radiology,Sichuan Academy of Medical Sciences&Sichuan Provincial People′s Hospital,Chengdu 610072,China)

机构地区：[1]川北医学院,四川南充637000 [2]四川省医学科学院·四川省人民医院放射科,四川成都610072

出　　处：《实用医院临床杂志》2022年第5期110-113,共4页Practical Journal of Clinical Medicine

摘　　要：目的 探讨双能CT的定量参数对局部进展期直肠癌患者新辅助治疗后疗效的评估价值。方法 回顾性纳入21例直肠癌患者,分为完全缓解组(TRG 0)和未完全缓解组(TRG 1-3);有效治疗组(TRG 0-1)和无效治疗组(TRG 2-3)。在双能量CT图像上独立采用全肿瘤体积勾画法对双能量CT的不同定量参数进行测定,分析不同的定量参数在上述两组之间的差异,绘制受试者工作特征曲线(ROC)明确各定量参数的诊断效能。结果 治疗前动脉期电子云密度(Rho)、治疗前静脉期Rho、动脉期Rho变化率、静脉期标准化碘浓度(nIC)变化率在治疗有效组和治疗无效组中差异有统计学意义(P<0.05),其AUC值分别为0.685、0.801、0.806、0.898。静脉期双能量指数(DEI)变化率、静脉期Z变化率、治疗前动脉期造影剂含量、治疗前静脉期造影剂含量、治疗后静脉期造影剂含量、治疗前动脉期Rho在新辅助治疗后完全缓解组和非完全缓解组中差异有统计学意义(P<0.05),其AUC值分别为0.727,0.713,0.597,0.667,0.769,0.685。结论 双能量CT测得的定量参数值能反应新辅助治疗后的疗效,其中静脉期nIC变化率在评估有效治疗和无效方面的诊断效能最高,而治疗后静脉期造影剂含量值在评估治疗完全缓解方面诊断效能最高。Objective To investigate the value of quantitative parameters of dual-energy CT(DECT) in the evaluation of efficacy of neoadjuvant therapy in patients with locally advanced rectal cancer.Methods Twenty-one patients with rectal cancer were retrospectively selected. According to postoperative pathological response, the patients were divided into a complete remission group(TRG 0) and an incomplete remission group(TRG 1-3), as well as a treatment response group(TRG 0-1) and a treatment non-response group(TRG 2-3). On the DECT images, the whole tumor volume delineation method was used to measure the different quantitative parameters of DECT independently. The differences in the quantitative parameters between the groups were analyzed. Receiver operating characteristic(ROC) curves were drawn to define the diagnostic performance of each quantitative parameter.Results There were statistically significant differences in arterial Rho, venous Rho, arterial Rho change rate, and venous nIC change rate between the treatment response group and the treatment non-response group before treatment(P<0.05). Their areas under curves(AUCs) were 0.685, 0.801, 0.806, and 0.898, respectively. There were statistically significant differences in double energy index(DEI) change rate, venous Z change rate, venous iodine concentration before treatment, arterial iodine concentration before treatment, venous iodine concentration after treatment, and arterial Rho before treatment between the complete remission group and the incomplete remission group(P<0.05). Their AUCs were 0.727,0.713,0.597,0.667,0.769,and 0.685, respectively.Conclusion Quantitative parameters of DECT can reflect the efficacy of neoadjuvant therapy for rectal cancer. The nIC change rate in venous phase is the highest in evaluating the treatment efficacy and inefficacy. The venous iodine concentration after treatment is the highest in diagnosing the complete and incomplete remission.

关 键 词：双能CT 新辅助化学疗法 直肠癌 疗效 

分 类 号：R816.5[医药卫生—放射医学]