CT能谱成像对卵巢囊腺瘤的诊断价值及其参数与免疫组织化学指标的相关性分析

The diagnostic value of spectral CT imaging in ovarian cystadenoma and the correlation between its parameters and immunohistochemical indexes

目的探究CT能谱成像对卵巢囊腺瘤的诊断价值及其参数与免疫组织化学指标的相关性。方法选取本院2015年5月至2018年5月确诊的134例卵巢囊腺瘤患者为研究对象,采用CT能谱成像进行扫描,获取结果后采用GSI viewer软件进行能谱图像分析,分别计算动、静脉期病变CT值与平扫CT值的差值(△CTm),同时取患者术中组织切片测定血管内皮生长因子(vascular endothelial growth factor,VEGF)、凋亡相关基因蛋白Smac和Survivin及微血管密度(microvessel density,MVD),并分析上述指标与CT能谱成像相关参数的相关性。结果 134例卵巢囊腺瘤患者中,病变位于左侧卵巢90例、右侧卵巢44例;CT平扫过程中可见病变部位局部增厚和增生组织。VEGF阳性患者动脉期标准化碘浓度(normalized iodine concentrations,NICs)和静脉期△CTm均显著高于VEGF阴性患者(P_均<0.05);VEGF阳性患者静脉期NICs显著低于VEGF阴性患者(P <0.05)。Survivin阳性患者静脉期NICs显著低于Survivin阴性患者(P <0.05)。Smac与动脉期和静脉期NICs、WCs、△CTm均无线性关系(P_均> 0.05);MVD与动脉期和静脉期NICs、△CTm均呈正相关(P_均<0.05)。结论卵巢囊腺瘤患者典型的CT能谱成像表现为病变部位局部增厚和增生组织;CT能谱成像参数与卵巢囊腺瘤患者免疫组织化学指标有一定相关性,有助于提高诊断效能。

Objective To explore the diagnostic value of spectral CT imaging in ovarian cystadenoma and the correlation between the parameters and immunohistochemical indexes. Method 134 patients with ovarian cystadenoma in our hospital from May 2015 to May 2018 were selected as the research objects, scaned with CT energy spectrum imaging, spectrum CT imaging was used for examination, the difference value （△CTm） between CT value and plain scan CT value in arterial and venous phase lesions was calculated respectively, the vascular endothelial growth factor （VEGF）, Smac, Survivin and microvessel density （MVD） of tissue sections were measured, the correlation between above indexes and spectral CT imaging related parameters were analyzed. Result The lesions of 134 patients with ovarian cystadenoma were located on the left ovary in 90 cases and the right ovary in 44 cases. Local thickening and hyperplastic tissue were seen in the lesion in the process of plain scan. Normalized iodine concentrations （NICs） in arterial phase and △CTm in venous phase of VEGF positive patients were significantly higher than those of VEGF negative patients （Pall 〈 0.05）. The NICs in venous phase of VEGF positive patients was significantly lower than that of VEGF negative patients （P 〈 0.05）. The NICs in venous phase of Survivin positive patients was significantly lower than that of Survivin negative patients （P 〈 0.05）. There were no relationship between Smac and NICs, WCs and △CTm in arterial phase and venous phase （Pall 〉 0.05）. There was positive correlation between MVD and NICs and △CTm in arterial phase and venous phase （Pall 〈 0.05）. Conclusion Typical spectral CT imaging in patients with ovarian cystadenoma shows local thickening and hyperplasia of the lesion. The parameters of spectral CT imaging are correlated with the immunohistochemical indexes of patients with ovarian cystadenoma, which is helpful to improve the diagnostic efficiency.