能谱CT定量参数联合MSCT三维重建在肺癌患者术前淋巴结转移评估中的应用价值  

Application Value of Quantitative Parameters of Energy Spectrum CT Combined with MSCT Three-dimensional Reconstruction in Preoperative Lymph Node Metastasis Assessment of Lung Cancer Patients

作　　者：李雅倩 刘义 刘百娜 LI Yaqian;LIU Yi;LIU Baina(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2025年第3期479-483,共5页The Practical Journal of Cancer

摘　　要：目的 分析能谱CT定量参数联合多层螺旋CT(MSCT)三维重建在肺癌患者术前淋巴结转移评估中的应用价值。方法 前瞻性纳入54例肺癌患者为研究对象。患者均在术前行能谱CT及MSCT三维重建检查,以术后病理诊断为金标准,分析能谱CT定量参数联合MSCT三维重建对肺癌患者术前淋巴结转移的评估价值。结果 54例肺癌患者手术共获134枚淋巴结,经术后病理诊断显示转移性淋巴结55枚,非转移性淋巴结79枚。转移性淋巴结标准化碘密度值(NIC)、有效原子序数(Eff-Z)、能谱曲线斜率(λHu)水平均低于非转移性淋巴结(P<0.05);2组标准化水密度值(NWC)水平比较,差异无统计学意义(P>0.05)。绘制受试者工作曲线,结果显示,NIC、Eff-Z、λHu评估肺癌患者术前淋巴结转移的曲线下面积(AUC)分别为0.745、0.713、0.798,均具有一定评估价值;经Kappa一致性检验,MSCT三维重建结果与病理检查结果的一致性一般(Kappa=0.515,P<0.001),而能谱CT定量参数联合MSCT三维重建结果与病理检查结果的一致性好(Kappa=0.764,P<0.05);能谱CT定量参数联合MSCT三维重建评估肺癌患者术前淋巴结转移的灵敏度、准确度、阴性预测值高于MSCT三维重建(P<0.05);MSCT三维重建与能谱CT定量参数联合MSCT三维重建的特异度、阳性预测值对比,差异无统计学意义(P>0.05)。结论 能谱CT定量参数对肺癌患者术前淋巴结转移具有一定评估价值,其与MSCT三维重建联合诊断与病理学诊断的一致性好,可为临床对肺癌患者术前淋巴结转移评估提供参考。Objective To analyze the application value of quantitative parameters of energy spectrum CT combined with three-dimensional reconstruction of multisliecs helieal CT(MSCT)in preoperative lymph node metastasis assessment of lung cancer patients.Methods A prospective study was conducted on 54 lung cancer patients.All patients underwent preoperative energy spectrum CT and MSCT three-dimensional reconstruction examinations,with postoperative pathological diagnosis as the gold standard.The evaluation value of energy spectrum CT quantitative parameters combined with MSCT three-dimensional reconstruction for preoperative lymph node metastasis in lung cancer patients was analyzed.Results A total of 134 lymph nodes were obtained from 54 lung cancer patients during surgery.Postoperative pathological diagnosis showed 55 metastatic lymph nodes and 79 non metastatic lymph nodes.The standardized iodine density(NIC),effective atomic number(Eff-Z),and energy spectrum curve slope(λHu)levels of metastatic lymph nodes were lower than those of non metastatic lymph nodes(P<0.05).There was no statistical significant difference in the level of normalized water density(NWC)between the 2 groups(P>0.05).The subject's work curve was drawn,and the results showed that the area under the curve(AUC)of NIC,Eff-Z,andλHu for evaluating preoperative lymph node metastasis in lung cancer patients were 0.745,0.713,and 0.798,respectively,all of which had certain evaluation value.According to Kappa consistency test,the consistency between MSCT three-dimensional reconstruction results and pathological examination results was average(Kappa=0.515,P<0.001),while the combination of energy spectrum CT quantitative parameters and MSCT three-dimensional reconstruction results showed good consistency with pathological examination results(Kappa=0.764,P<0.05).The sensitivity,accuracy,and negative predictive value of combining quantitative parameters of energy spectrum CT with MSCT three-dimensional reconstruction in evaluating preoperative lymph node metastasis

关 键 词：肺癌 能谱CT 多层螺旋CT三维重建 淋巴结转移 

分 类 号：R734.2[医药卫生—肿瘤]