双源CT碘浓度及Overlay值诊断不同分化程度胃癌及转移淋巴结

Dual-source CT iodine concentration and Overlay value in diagnosis of different degree gastric cancer and metastatic lymph nodes

目的探讨双源CT双能扫描动脉期碘浓度及Overlay值在诊断不同分化程度胃癌及转移淋巴结中的价值。方法回顾性分析46例术前接受双源CT扫描并经术后病理证实的胃癌伴淋巴结转移患者的资料,测量病灶及转移淋巴结碘浓度、Overlay值。根据病理分化程度将胃癌病灶及转移淋巴结分为分化良好组(病理结果为高分化、中高分化、中分化)与分化不良组(病理结果为中低分化、低分化)。采用独立样本t检验比较2组间胃癌及转移淋巴结碘浓度、Overlay值;并绘制ROC曲线,评价其诊断不同分化程度胃癌及转移淋巴结的效能。结果 46例胃癌病灶中分化良好组15例,分化不良组31例;73枚转移淋巴结中分化良好组24枚,分化不良组49枚。分化不良组胃癌、转移淋巴结碘浓度为(2.12±0.72)mg/ml和(1.85±0.67)mg/ml,Overlay值为(37.32±13.18)HU和(32.24±12.10)HU,均高于分化良好组(P均<0.05)。动脉期碘浓度及Overlay值诊断胃癌分化程度的AUC分别为0.799、0.745(P=0.001、0.008),诊断转移淋巴结分化程度的AUC分别为0.787、0.733(P<0.001、P=0.001)。结论动脉期碘浓度及Overlay值对诊断不同分化程度胃癌及转移淋巴结有一定价值,可为术前评估其分化程度提供依据。

Objective To explore the value of dual-source CT dual-energy scanning iodine concentration and Overlay value at the arterial phase in diagnosing gastric cancer and metastatic lymph node with different degrees of differentiation. Methods Data of 46 patients with gastric cancer and lymph node metastasis who underwent preoperative dual-source CT and confirmed by postoperative pathology were enrolled.The iodine concentration and Overlay value of gastric cancer and metastatic lymph nodes were measured.According to pathological differentiation degree,the gastric cancer lesions and metastatic lymph nodes were divided into well differentiated group and poorly differentiated group.Independent sample t-test was used to compare the differences of iodine concentration and Overlay value between the two groups of gastric cancer and metastatic lymph nodes.ROC curve was used to evaluate the efficacy in diagnosis of gastric cancer and metastatic lymph nodes with different differentiation.Results Among 46 patients,15 were found with well-differentiated gastric cancer and 31 with poorly differentiated gastric cancer.Among 73 metastatic lymph nodes,24 were welldifferentiated and 49 were poorly differentiated.In poorly differentiated group,the iodine concentration of gastric cancer and metastatic lymph nodes was (2.12±0.72)mg/ml and (1.85±0.67)mg/ml,respectively,and the Overlay value was (37.32±13.18)HU and (32.24±12.10)HU,respectively,higher than those of well differentiated group (all P<0.05). AUC of iodine concentration and Overlay value in diagnosis of gastric cancer differentiation were 0.799 and 0.745(P= 0.001,P=0.008),in diagnosis of lymph nodes was 0.787 and 0.733,respectively (P<0.001,P=0.001).Conclusion The iodine concentration and Overlay value at the arterial phase have certain role in evaluating differentiation degree of gastric cancer and metastatic lymph nodes,which can provide references for differentiation degree of gastric cancer before surgical operation.