标准化碘浓度在颈部鳞状细胞癌转移淋巴结分化程度中的诊断价值

Diagnosis of Normalized Iodine Concentration in Diagnosing Cervical Squamous Cell Carcinoma Metastatic Lymph Nodes Differentiation Degree

目的通过双源CT双能量技术的多参数分析,探讨标准化碘浓度测量在术前鉴别颈部鳞状细胞癌(鳞癌)转移淋巴结中的应用价值。资料与方法回顾性分析经病理证实的29例患者,共计105枚颈部淋巴结,均行双能量双期增强扫描,测量动脉期及静脉期不同分化程度淋巴结实质碘浓度及标准化碘浓度,比较两种不同分化程度淋巴结、原发灶碘浓度及标准化碘浓度的差异。结果 29例患者中,原发于鼻咽癌14例,喉癌12例,舌癌2例,腮腺癌1例。在动脉期与静脉期,低分化鳞癌与中高分化鳞癌原发病灶的碘浓度与标准化碘浓度间差异均无统计学意义(P>0.05)。在动脉期与静脉期,低分化鳞癌转移性淋巴结与中高分化鳞癌转移性淋巴结标准化碘浓度差异均有统计学意义,其中低分化鳞癌转移性淋巴结的标准化碘浓度更高(P<0.05);在动脉期,两组碘浓度差异无统计学意义(P>0.05);在静脉期,两组碘浓度差异有统计学意义(P<0.05)。结论应用双源CT双能量成像技术的标准化碘浓度测量对于不同分化程度的鳞癌转移淋巴结性质的鉴别诊断有一定的价值。

Purpose To explore the application value of dual energy imaging in differential diagnosis of cervical squamous cell carcinoma metastatic lymph nodes differentiation degree using dual energy CT multi parameter analysis. Materials and Methods Twenty-nine pathology confirmed patients with one hundred and five cervical enlarged lymph nodes were analyzed respectively, all the patients enrolled underwent dual energy dual phase contrasted-enhanced CT scan, the iodine concentration and normalized iodine concentration（NIC） of the lymph nodes＇ parenchyma with different degree of differentiation were measured in both arterial and venous phase, the differences of iodine concentration and NIC of primary foci and metastatic lymph nodes form low differentiated and high differentiated cervical squamous cell carcinoma were measured and compared. Results For 29 patients, 14 cases of primary nasopharyngeal carcinoma, 12 cases of laryngeal carcinoma, 2 cases of tongue carcinoma, 1 case of carcinoma of the parotid gland. There was no statistically significant difference on iodine concentration and NIC between the low differentiated and high differentiated cervical squamous cell carcinoma primary foci in both arterial phase and portal venous phase（P〈0.05）; statistically significant differences of NIC were found between the low differentiated and high differentiated cervical squamous cell carcinoma metastatic lymph nodes at arterial phase and venous phase（P〈0.05）, with low differentiated squamous cell carcinoma metastatic lymph nodes showing higher NIC（P〈0.05）; the iodine concentration at venous phase showed significant difference between the two groups（P〈0.05）; while differences of iodine concentration at arterial phase between the two groups were not statistically significant（P〈0.05）. Conclusion The NIC of dual source CT dual energy imaging can be used for the differential diagnosis of cervical squamous cell carcinoma metastatic lymph nodes differentiation degree.