CT能谱成像在胃癌术前分化程度评估中的应用

Study of Spectral CT Imaging in Diagnosis of Differentiation of Gastric Carcinoma

目的 通过分析不同分化程度胃癌在能谱成像上的一些参数及特征,初步探讨CT能谱成像在胃癌诊断中的应用价值.方法 回顾性分析经病理证实的30例胃癌影像资料,其中分化组13例,未分化组17例,所有患者均行CT能谱双期扫描.于能谱图像后处理站选择测量区域,分别记录双期扫描正常胃壁及所有病灶在不同单能量水平下CT值、碘-水浓度、有效原子序数等进行统计学分析,并进行独立样本t检验.结果 静脉期40～90 kev各单能量水平下中、高分化组的CT值均低于低分化组,且低分化组的能谱曲线斜率（4.02±1.52）明显大于中、高分化组（2.69±0.18）;静脉期低分化组碘基值（27.30±4.51）、有效原子序数（9.12±0.24）分别高于中、高分化组碘基值（18.52±9.43）、有效原子序数（8.51±0.44）,差异具有统计学意义（P〈0.05）;动脉期碘基值、有效原子序数及双期水基值差异无统计学意义（P〉0.05）.结论 CT能谱多参数成像的特点能够对组织病变进行定量分析,碘浓度、有效原子序数及能谱曲线有助于胃癌分化程度评估.

Objective To analyze the features of differentiation of gastric carcinoma, and investigate the value of spectral CT imaging in its diagnosis. Methods 30 cases originating from stomach confirmed by pathology were analyzed retrospectively. 30 gastric carcinoma were further grouped into two groups： 13 cases as differentiated group and 17 cases as undifferentiated group. All patients went through GSI imaging. After that, we took the arterial phase and venous phase images, and at the same time, we got iodine based images and water based images. Afterward we analyzed the data. Finally, independent samples t test was used to examine those data. Results In venous phase, the undifferentiated tumors has higher CT values between 40～90 kev, with higher slope value （4.02±1.52） than differentiated group （2.69±0.18）. The iodine-concentration and effective-Z in venous phase, undifferentiated group （27.30±4.51, 9.12±0.24） is also higher than differentiated group （18.52±9.43, 8.51±0.44）. Differences of water-concentration between two groups was not found （P〉0.05）. Conclusion Spectral CT imaging has muti-parameter function, which can offer quantitative analysis, and has potential worth in evaluating the differentiation of the gastric cancer with iodine-concentration, the effective-Z and CT values.