CT能谱成像对结直肠癌术前N分期的评估价值分析  

Evaluation Value of CT Spectral Imaging for Preoperative N-Staging of Colorectal Cancer

作　　者：师新宇 杨中杰 韩萌 SHI Xin-yu;YANG Zhong-jie;HAN Meng(Department of Radiology,Henan Provincial Hospital of Traditional Chinese Medicine(Second Affiliated Hospital of Henan University of Traditional Chinese Medicine),Zhengzhou,Henan 450000)

机构地区：[1]河南省中医院(河南中医药大学第二附属医院)放射科,河南郑州450000

出　　处：《中国肛肠病杂志》2025年第2期19-21,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨CT能谱成像对结直肠癌术前N分期的评估价值。方法:对2022年3月至2024年3月于我院拟择期手术治疗的80例结直肠癌患者进行CT能谱动、静脉双期增强成像扫描,根据术后病理将纳入的淋巴结分为转移性淋巴结组和非转移性淋巴结组,比较2组淋巴结短径、边缘、聚集和强化均匀度,以及60 kV单能量水平下清晰显示淋巴结最大层面时的碘浓度(IC)、标准化碘浓度(NIC)、能谱曲线斜率(λ_(HU))。以受试者工作特征(ROC)曲线分析CT能谱成像对N分期的诊断效能。结果:共纳入100枚淋巴结,其中转移性56枚,非转移性44枚。转移性淋巴结与非转移性淋巴结的冠状位短径、矢状位短径、边缘清晰度、聚集情况和强化均匀度、动脉期IC、静脉期IC、动脉期NIC、动脉期λ_(HU)、静脉期λ_(HU)均具有显著差异,P<0.05。ROC曲线显示矢状位短径、冠状位短径Cut-off值分别为8.8 mm和9.8 mm,对应曲线下面积(AUC)分别为0.735和0.681;动脉期IC、静脉期IC、动脉期NIC、动脉期λ_(HU)、静脉期λ_(HU) AUC分别为0.852、0.832、0.820、0.740、0.828;动脉期IC 18.68(100μg/cm^(3))作为诊断淋巴结转移的Cut-off值,其敏感性、特异度分别为94.81%和69.18%。结论:CT能谱成像评估结直肠癌术前N分期具有一定价值,各参数中动脉期IC诊断性能更高,值得临床参考。Objective To investigate the value of CT spectral imaging for preoperative N-staging of colorectal cancer.Methods From March 2022 to March 2024,total 80 patients with colorectal cancer undergoing elective surgery in our hospital were scanned with dual-phase enhanced CT spectral imaging.According to the postoperative pathology,the included lymph nodes were divided into the metastatic lymph node group and the non-metastatic lymph node group,and the short diameter,edge,clustering and enhancement uniformity of the two groups of lymph nodes were compared.The iodine concentration(IC),normalized iodine concentration(NIC),and spectral curve slope(λ_(HU))at the maximum level of the lymph node were clearly displayed at 6OkV monochromatic energy level.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of CT spectral imaging for N-staging.ResultsA total of 100 lymph nodes were included,including 56 metastatic lymph nodes and 44 non-metastatic lymph nodes.There were significant differences in the coronal short diameter,sagittal short diameter,edge sharpness,aggregation and enhancement uniformity,IC in arterial phase,IC in venous phase,NIC in arterial phase,Au in arterial phase andλ_(HU) in venous phase between metastatic lymph nodes and non-metastatic lymph nodes(P<0.05).ROC curve showed that the Cut-off values of sagittal and coronal short diameter were 8.8 mm and 9.8 mm,respectively,and the corresponding area under the curve(AUC)were 0.735 and 0.681,respectively.The AUC of IC in arterial phase,IC in venous phase,NIC in arterial phase,λ_(HU) in arterial phase and hu in venous phase were 0.852,0.832,0.820,0.740 and 0.828,respectively.Arterial phase IC 18.68(100μg/cm^(3))was used as the Cut-off value for the diagnosis of lymph node metastasis,and its sensitivity and specificity were 94.81%and 69.18%,respectively.Conclusion CT spectral imaging has a certain value in evaluating the preoperative N-staging of colorectal cancer.Among the parameters,the diagnostic performance of IC in art

关 键 词：结直肠癌 CT能谱成像 N分期 诊断 

分 类 号：R73[医药卫生—肿瘤] R735.3[医药卫生—临床医学]