基于肿瘤影像学异质性分析CT在诊断青年胃癌的价值

The value of CT in the diagnosis of young gastric cancer based on tumor imaging heterogeneity

目的:探讨基于肿瘤影响学异质性分析CT诊断青年胃癌的意义。方法:采用回顾性分析的研究方法纳入我院2016年5月-2017年8月青年胃癌的患者68例,采用浸润溃疡型26例,息肉型24例,弥漫浸润型18例。采用单层面灌注CT和容积灌注CT扫描,比较两种方法对青年胃癌的诊断效果,评价两者的影像学异质性差异,评价其在肿瘤影像学异质性对青年胃癌的诊断效能。结果:单层面灌注CT成像对诊断胃癌的阴性预测值、阳性预测值、准确性、特性性、敏感性分别为84.1%、92.8%、70.6%、72.8%、95.6%,容积灌注CT成像对诊断胃癌的阴性预测值、阳性预测值、准确性、特性性、敏感性分别为84.6%、92.7%、70.5%、74.2%、95.4%,差异无统计学意义(P>0.05);血流量差异性在中高分化组、低分化组容积灌注CT成像与单层面灌注CT的比较:高分化组容积灌注CT血流量值(33.67±11.34)m L/min、变异率38.5%,单层面灌注CT血流量值(32.77±13.35)m L/min、变异率40.6%,中高分化亚组容积灌注CT血流量值(34.24±13.45)m L/min、变异率38.6%,单层面灌注CT血流量值(37.85±15.22)m L/min、变异率41.1%,低分化亚组容积灌注CT血流量值(29.36±11.23)m L/min、变异率37.3%,单层面灌注CT血流量值(27.74±11.76)m L/min、变异率40.6%,血流量差异性比较,差异具有统计学意义(P<0.05);变异系数在中高分化组、低分化组容积灌注CT成像与单层面灌注CT的比较,差异有统计学意义(P<0.05)。结论:青年胃癌肿瘤血流量对肿瘤影像学异质性有一定影响,单层面灌注CT与容积灌注CT成像比较差异无统计学意义,容积灌注CT成像的变异系数更小。

Objective:To explore the significance of CT in the diagnosis of young gastric cancer based on tumor imaging heterogeneity.Methods:The retrospective analysis was carried out in 68 patients with gastric cancer in our hospital from May 2016 to August 2017,with 26 cases of invasive ulcer type,24 cases of polyp and 18 cases of infiltration.A single level of perfusion CT and volume perfusion CT scans were applied and the comparison of two methods in diagnosis of youth gastric cancer effect was made to evaluate the imaging heterogeneity differences of two methods,and to evaluate its heterogeneity in tumor imaging for youth gastric cancer diagnosis efficiency.Results:The negative predictive value,positive predictive value and accuracy of the diagnosis of gastric cancer,characteristics,sensitivity of single level perfusion CT imaging was 84.1%,92.8%,70.6%,72.8%and 70.6%respectively while that of the volume perfusion CT imaging was 84.6%,92.7%,70.5%,74.2%,and 70.5%respectively,there was no statistically significant differences(P>0.05).Comparison of the blood flow difference of volume infusion CT imaging and the single-layer perfusion CT between the middle and high differentiation group and the low differentiation group was made.In well-differentiated group,perfusion CT volume blood flow magnitude was(33.67±11.34),the variation rate was 38.5%,the single level perfusion CT blood flow magnitude was(32.77±13.35),the variation rate was 40.6%.In the high differentiation subgroup,perfusion CT volume blood flow magnitude was(34.24±13.45),the variation rate was 38.6%,single level perfusion CT blood flow magnitude was(37.85±15.22),the variation rate was 41.1%;In the low perfusion CT differentiation subgroup,volume blood flow magnitude was(29.36±11.23),the variation rate was 37.3%.The blood flow difference was statistically significant(P<0.05).There was a statistical difference in the comparison of CT imaging and single-layer perfusion CT in the middle and high differentiation group and low differentiation group(P<0.05).Conclusion:Youth gastric cancer tumor blood flow had certain influence on the heterogeneity of tumor imaging,there was no statistically significant difference between a single level of perfusion CT and volume perfusion CT scans,the variation coefficient of perfusion CT imaging was smaller.