灌注成像参数联合三维重建对胃癌患者腹腔镜手术后淋巴结转移的临床分析

Clinical Analysis of Perfusion Imaging Parameters Combined with Three-dimensional Reconstruction for Lymph Node Metastasis after Laparoscopic Surgery in Patients with Gastric Cancer

目的:观察灌注成像参数联合三维重建对胃癌患者腹腔镜手术后淋巴结转移的评估价值.方法:回顾性分析2018年1月至2020年1月医院收治的107例胃癌患者的临床资料,均于腹腔镜手术后行CT灌注成像检查,并应用三维重建技术,以病理学检查结果为金标准,评估灌注成像参数联合三维重建对胃癌患者术后淋巴结转移的评估价值.结果:107例胃癌患者中,21例发生术后淋巴结转移,86例未发生术后淋巴结转移,两组基线资料比较,差异无统计学意义(P>0.05);淋巴结转移组Patlak表面通透性(PPS)、Patlak血容量(PBV)、淋巴结最大横径及淋巴结短长径比值均高于未发生淋巴结转移组,差异有统计学意义(P<0.05);绘制受试者工作特性曲线(ROC)发现,灌注成像参数联合三维重建单项评估及联合评估胃癌患者淋巴结转移的曲线下面积(AUC)均>0.70,均有一定评估价值,且以联合评估的AUC最大.结论:灌注成像参数联合三维重建对胃癌患者腹腔镜手术后淋巴结转移有较高评估价值,值得临床推广应用.

Objective:To observe the evaluation value of perfusion imaging parameters combined with 3D reconstruction for lymph node metastasis after laparoscopic surgery in patients with gastric cancer.Methods:The clinical data of 107 patients with gastric cancer treated in the hospital from January 2018 to January 2020 were analyzed retrospectively,CT perfusion imaging was performed after laparoscopic surgery,and applyed 3D reconstruction technology,the pathological examination results were taken as the gold standard,the evaluation value of perfusion imaging parameters combined with 3D reconstruction for postoperative lymph node metastasis in patients with gastric cancer was evaluated.Results:Among 107 patients with gastric cancer,21 had postoperative lymph node metastasis and 86 did not have postoperative lymph node metastasis;there was no statistical significant difference in co mparison baseline data between two groups(P>0.05);the Patlak permeability surface(PPS),Patlak blood volume(PBV),the maximum transverse diameter of lymph nodes and the ratio of short to long diameter of lymph nodes in the lymph node metastasis group were higher than those in the non lymph node metastasis group,the difference was statistically significant(P<0.05);the receiver operating characteristic curve(ROC)was drawn and found that,the area under the curve(AUC)of perfusion imaging parameters combined with 3D reconstruction for single and combined evaluation lymph node metastasis in patients with gastric cancer(AUC>0.70),all had certain evaluation value,and the AUC of joint evaluation was the largest.Conclusion:Perfusion imaging parameters combined with 3D reconstruction are of high value in evaluating lymph node metastasis after laparoscopic surgery in patients with gastric cancer,which is worthy of clinical application.