能谱CT诊断直肠癌浆膜外浸润

Spectral CT Diagnosis of Rectal Cancer Pericolic Infiltration

目的探讨能谱CT双能量成像诊断直肠癌浆膜外浸润的价值。资料与方法回顾性分析经双源CT双能量扫描并经手术病理证实的直肠癌患者62例,其中发生浆膜外浸润25例,仅浆膜受侵未突破浆膜37例。比较两种不同侵犯程度直肠癌肠周脂肪组织动、静脉期碘浓度、能谱曲线斜率(K),并应用受试者工作特性曲线评价碘浓度及K值诊断直肠癌发生浆膜外浸润的效能。结果动、静脉期直肠癌浆膜外浸润组与仅浆膜受侵组肠周脂肪组织碘浓度及K值差异均有统计学意义(P<0.05),且动、静脉期碘浓度判断直肠癌浆膜外浸润敏感度及特异度均高于动、静脉期K值;动、静脉期碘浓度判断直肠癌发生浆膜外浸润的曲线下面积分别为0.837、0.707,敏感度和特异度分别为:动脉期60.7%、95.2%;静脉期46.4%、90.5%。结论双能量成像测量动、静脉期碘浓度及K值对判断直肠癌发生浆膜外浸润有一定的价值。

Purpose To explore the value of dual-energy imaging technique of spectral CT in diagnosing rectal cancer pericolic infiltration.Materials and Methods Sixty-two patients with rectal cancer underwent dual-source CT dual-energy scan and confirmed by surgical pathology were retrospectively analyzed,among them 25 cases were those with pericolic infiltration,with only 37 cases of serosal invasion failed to break through the serosa.The iodine concentration and energy spectrum curve slope（K） in the arterial and venous phase of perienteric adipose tissue with two different degrees of invasion were statistically analyzed,and the receiver operating characteristic curve was used to evaluate iodine concentration and K value to diagnose the ability of rectal cancer to develop pericolic infiltration.Results The difference in terms of iodine concentration and K value of perienteric adipose tissue between rectal cancer pericolic infiltration group and the group that only had serosal invasion in arterial and venous phase was statistically significant（P0.05）.The sensitivity and specificity of iodine concentration in arterial and venous phase judging rectal cancer pericolic infiltration were all higher than K value in arterial and venous phase; the area under the curve of iodine concentration in arterial and venous phase judging rectal cancer pericolic infiltration were 0.837 and 0.707,respectively; and the sensitivity and specificity were： arterial phase 60.7%,95.2%; venous phase 46.4%,90.5%.Conclusion The measurement of iodine concentration and K value in arterial and venous phase using dualenergy imaging is of certain value in judging rectal cancer pericolic infiltration.