能谱CT多参数成像术前预测胃癌淋巴结转移  

Spectral CT multi-parameter imaging for preoperative predicting lymph node metastasis of gastric cancer

作　　者：陈俣菘 刘译阳 赵帅 袁梦晨 李卫星[5,6] 尤亚茹 郑月 范松梅 高剑波 CHEN Yusong;LIU Yiyang;ZHAO Shuai;YUAN Mengchen;LI Weixing;YOU Yaru;ZHENG Yue;FAN Songmei;GAO Jianbo(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Henan International Joint Laboratory of Medical Imaging,Zhengzhou 450052,China;Henan Key Laboratory of Image Diagnosis and Treatment for Digestive System Tumor,Zhengzhou 450052,China;Henan Key Laboratory of CT Imaging,Zhengzhou 450052,China;Department of CT,Xinxiang Central Hospital,Xinxiang 453099,China;The Fourth Clinical College of Xinxiang Medical University,Xinxiang 453099,China)

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052 [2]河南省医学影像国际联合实验室,河南郑州450052 [3]河南省消化肿瘤影像重点实验室,河南郑州450052 [4]河南省CT影像重点实验室,河南郑州450052 [5]新乡市中心医院CT室,河南新乡453099 [6]新乡医学院第四临床学院,河南新乡453099

出　　处：《中国介入影像与治疗学》2024年第10期596-601,共6页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察能谱CT多参数成像术前预测胃癌淋巴结转移(LNM)的价值。方法回顾性分析136例胃腺癌患者,根据术后病理显示淋巴结状态将其分为LNM组(n=74)与非LNM组(n=62);比较组间临床资料、常规CT表现及能谱CT参数,将组间差异有统计学意义的因素纳入多因素logistic回归分析筛选胃癌LNM的独立预测因素,据以分别构建临床+常规CT模型(模型1)、能谱CT模型(模型2)及联合模型(模型3)。绘制受试者工作特征曲线,计算曲线下面积(AUC),评估各模型术前预测胃癌LNM的效能。结果CT-N分期、CT-T分期,动脉期(AP)70、100及140 keV CT值_(肿瘤),动脉增强分数(AEF)及静脉期标准碘浓度(NICVP)均为胃癌LNM的独立预测因素(P均<0.05)。模型3术前预测胃癌LNM的AUC为0.846,高于模型1及模型2(AUC=0.767、0.774,Z=-0.368、-2.373,P均<0.05),而模型1、2间差异无统计学意义(Z=-0.152,P=0.879)。结论能谱CT多参数成像可于术前有效预测胃癌LNM。Objective To observe the value of spectral CT multi-parameter imaging for preoperative predicting lymph node metastasis(LNM)of gastric cancer.Methods Totally 136 patients with gastric adenocarcinoma were retrospectively enrolled.The patients were further divided into LNM group(n=74)and non-LNM group(n=62)according to postoperative pathological findings of lymph nodes status.Clinical data,conventional CT findings and spectral CT parameters were compared between groups.Factors being significant different between groups were included in multivariate logistic regression analysis to screen independent predictors of gastric cancer LNM.Clinical+conventional CT model(model 1),spectrum CT model(model 2)and combined model(model 3)were constructed based on the above independent predictors,respectively.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each model for preoperative predicting LNM of gastric cancer.Results CT-N stage,CT-T stage,70,100 and 140 keV CT valuestumor at arterial phase(AP),arterial enhancement fraction(AEF)and normalized iodine concentration at venous phase(NICVP)were all independent predictors of gastric cancer LNM(all P<0.05).AUC of model 3 was 0.846,higher than that of model 1 and model 2(AUC=0.767,0.774,Z=-0.368,-2.373,both P<0.05)for preoperative predicting LNM of gastric cancer,while the latter two were not significantly different(Z=-0.152,P=0.879).Conclusion Spectral CT multi-parameter imaging could effectively predict LNM of gastric cancer preoperatively.

关 键 词：胃肿瘤 淋巴结转移 体层摄影术 X线计算机 能谱成像 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]