螺旋CT能谱成像对结直肠癌病理分化程度的诊断价值  

Diagnostic value of spiral CT spectral imaging in the pathological differentiation degree of colorectal cancer

作　　者：李泽茂 冯莉 王星稳 周伟 陈伟彬 Li Zemao;Feng Li;Wang Xingwen(Room of CT,the Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院CT室,河北唐山063000 [2]华北理工大学基础医学院,河北唐山063000

出　　处：《华北理工大学学报（医学版）》2024年第2期94-100,共7页Journal of North China University of Science and Technology：Health Sciences Edition

基　　金：2023年度唐山市人才资助项目(编号:C202303027)。

摘　　要：目的 探讨术前应用CT能谱成像技术预测结直肠癌患者病理分化程度的准确性。方法 收集2019年9月~2022年12月于华北理工大学附属医院经术前结肠镜或手术病理确诊为结直肠癌的患者82例。依据结直肠癌病理分化程度分为中高分化组(62例)和低分化组(20例)。采用GE Revolution CT扫描仪对患者进行能谱成像扫描,测量并记录动、静脉期病灶40~140kev单能量CT值、碘基值(IC)、水基值(WC)以及有效原子序数(Eff-Z),并计算标准化碘基值(NIC)和能谱曲线斜率(λ)。结果 动脉期:低分化组40~140kev单能量CT值均高于中高分化组(P<0.05);低分化组结直肠癌IC、NIC、λ均高于中高分化组(P<0.05)。静脉期:低分化组40~130kev单能量CT值均高于中高分化组(P<0.05),低分化组结直肠癌IC、NIC、λ、Eff-Z均高于中高分化组(P<0.05)。相比于动脉期,静脉期40~90kev单能量CT值及能谱参数IC+NIC+λ+Eff-Z联合预测结直肠癌不同分化程度的效能较好,其AUC为0.943。结论 能谱CT成像可以在术前较好的预测结直肠癌分化程度,为临床医师提供影像学依据。Objective To explore the accuracy of preoperative CT spectral imaging in predicting the pathological differentiation of colorectal cancer patients.Methods 82 patients with colorectal cancer confirmed by preoperative colonoscopy or surgical pathology in Affiliated Hospital of North China University of Science and Technology from September 2019 to December 2022 were collected.According to the pathological differentiation degree of colorectal cancer,they were divided into the moderately and highly differentiated group(62 cases)and the poorly differentiated group(20 cases).GE RevolutionCT scanner was used to perform spectral imaging scan on the patients,and the single-energy CT values,iodine concentration(IC),water concentration(WC),and effective atomic number(Eff-Z)of the lesions in the arterial and venous phases at 40~140kev were measured and recorded.In addition,normalized iodine concentration(NIC)and spectral curve slope(λ)were calculated.Results In the arterial phase,the single-energy CT values of the poorly differentiated group at 40~140kev were higher than those of the moderately and highly differentiated group(P<0.05).The IC,NIC,andλof colorectal cancer in the poorly differentiated group were also higher than those in the moderately and highly differentiated group(P<0.05).In the venous phase,the single-energy CT values of the poorly differentiated group at 40~130kev were higher than those of the moderately and highly differentiated group(P<0.05).Additionally,the IC,NIC,λ,and Eff-Z of colorectal cancer in the poorly differentiated group were higher than those in the moderately and highly differentiated group(P<0.05).Compared with the arterial phase,the single-energy CT values at 40~90kev and the combined prediction of spectral parameters IC+NIC+λ+Eff-Z in the venous phase had better performance in predicting the different degrees of differentiation of colorectal cancer,with an AUC of 0.943.Conclusion Spectral CT imaging can effectively predict the differentiation degree of colorectal cancer before surgery,

关 键 词：结直肠癌 分化程度 能谱成像 单能量CT值 

分 类 号：R445[医药卫生—影像医学与核医学]