双能光谱CT在鼻咽癌病灶评估及疗效评价中的应用研究  

Application of dual-energy spectral CT in evaluating nasopharyngeal carcinoma lesions and its therapeutic efficacy

作　　者：王允侬 康铮 李阳[2] 乔伟 李康 张秀明[1] WANG Yunnong;KANG Zheng;LI Yang;QIAO Wei;LI Kang;ZHANG Xiuming(Imaging Center,Jiangsu Cancer Hospital/Jiangsu Institute of Cancer Research/The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,China;Department of Radiation Oncology,Jiangsu Cancer Hospital/Jiangsu Institute of Cancer Research/The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,China)

机构地区：[1]南京医科大学附属肿瘤医院(江苏省肿瘤医院,江苏省肿瘤防治研究所)影像科,江苏南京210009 [2]南京医科大学附属肿瘤医院(江苏省肿瘤医院,江苏省肿瘤防治研究所)放疗科,江苏南京210009

出　　处：《现代医学》2024年第11期1674-1680,共7页Modern Medical Journal

基　　金：江苏省肿瘤医院青蓝人才计划(ZM201504);江苏省肿瘤医院科研项目(ZL202116);第66批中国博士后科学基金面上资助二等资助(2019M661774)。

摘　　要：目的:探讨双能光谱CT碘浓度(IC)值、有效原子序数(Zeff)及电子云密度(ED)值在鼻咽癌病灶评估及疗效评价中的价值。方法:回顾性收集2022年8月至2023年7月间江苏省肿瘤医院放疗科收治的经病理确诊鼻咽癌患者40例,整理其临床及影像学资料。其中男32例,女8例,平均年龄(53.00±13.83)岁。依据病灶初诊情况分为3组:T1、T2组,T3组,T4组。根据RECIST标准分为有效组、稳定组及进展组。所有患者在治疗前和第1个治疗疗程结束后行双能光谱CT增强扫描,观测治疗前后病灶的范围,测量增强的各参数值:IC、Zeff及ED,并计算归一化碘浓度(NIC)。结果:基于分组显示T1、T2组9例,T3组14例,T4组17例,对病灶及淋巴结的Zeff值、ED值及NIC值进行统计学分析,组间差异无统计学意义(P>0.05),但是较常规CT增强图像,上述后处理伪彩图能敏感、清晰地显示病灶的范围及边界。基于RECIST标准分组显示有效组21例,稳定组19例,无进展病例,40例鼻咽癌患者治疗后病灶及淋巴结的Zeff值、ED值及NIC值均小于治疗前,差异均有统计学意义(P<0.05)。结论:双能光谱CT在鼻咽癌病灶评估及疗效评价的应用中具有较好的临床实用价值。Objective:To explore the value of dual-energy spectral CT iodine concentration(IC)value,effective atomic number(Zeff)and electron cloud density(ED)value in assessing nasopharyngeal carcinoma lesions and evaluating therapeutic efficacy.Methods:The clinical and imaging data of 40 nasopharyngeal carcinoma patients diagnosed by pathology admitted to the radiotherapy department of Jiangsu Cancer Hospital between August 2022 and July 2023 were retrospectively collected.Among them,32 cases were male and 8 cases were female,with an average age of(53.00±13.83)years.The 40 nasopharyngeal cancer patients were divided into T1,T2 group,T3 group and T4 group.It was divided into effective,stable,and progressive groups according to RECIST criteria.All patients underwent dual-energy spectral CT enhancement scanning before treatment and at the end of the first treatment course,the extent of the lesions before and after treatment observed,the values of each parameter of enhancement measured including IC,Zeff and ED,and calculating the normalized iodine concentration(NIC).Results:Based on the grouping,there were 9 cases in T1,T2 group,14 cases in T3 group and 17 cases in T4 group,and the Zeff,ED,and NIC values of lesions and lymph nodes were statistically analyzed,and the differences between groups were not statistically significant(P>0.05),but compared with the conventional CT-enhanced images,the processed pseudo-color maps could sensitively and clearly show the extent and boundaries of the lesions.Grouping based on RECIST criteria showed 21 cases in the effective group,19 cases in the stable group,and no progressed cases.The processed pseudo-color maps of 40 nasopharyngeal carcinoma patients after treatment showed the Zeff value,ED value,and NIC value of lesions,and lymph nodes after treatment were smaller than those before treatment,and the differences were statistically significant(P<0.05).Conclusion:Dual-energy spectral CT has good clinical value in the evaluation of nasopharyngeal carcinoma lesions and treatment efficacy.

关 键 词：能谱CT 碘浓度 鼻咽癌 疗效评价 

分 类 号：R445.3[医药卫生—影像医学与核医学]