双源CT的标准化碘浓度值在鉴别中低分化胃腺癌与胃间质瘤中的诊断价值

Diagnostic value of normalized iodine concentration of dual source CT between low-moderate diffenrentiated gastric adenocarcinoma and gastric stromal tumor

目的:探讨双源CT碘图的标准化碘浓度(NIC)值在鉴别中低分化胃腺癌与胃间质瘤中的诊断价值。方法:选取甘肃省人民医院收治的31例中低分化胃腺癌患者及18例胃间质瘤患者,术前均行双源CT双能量两期增强扫描,采用Siemenssyngoviewer工作站的VNC后处理软件,测量动脉期、门脉期病灶与腹主动脉的碘浓度(IC),并计算出NIC值。比较中低分化胃腺癌与胃间质瘤在组间动、门脉期测量的NIC值差异,并筛查出最具诊断效能的期相。结果:在碘图中,门脉期中低分化胃腺癌的供血高于胃间质瘤,体积较大的胃间质瘤不均质性较高;中低分化胃腺癌在门脉期的NIC值高于胃间质瘤(P<0.05);受试者工作特征(ROC)曲线显示:门脉期NIC值在鉴别中低分化胃腺癌与胃间质瘤的灵敏度、特异度分别96.8%、50.0%,ROC曲线下面积为0.713。结论:碘图能直观反映中低分化胃腺癌及胃间质瘤的供血情况,双源CT门脉期的NIC值可以鉴别中低分化胃腺癌与胃间质瘤。

Objective: To evaluate the diagnostic value of normalized iodine concentration (NIC) on dual-source CT iodine maps in low-moderate differentiated gastric adenocarcinoma and gastric stromal tumor. Methods: Preoperative two phase dynamic contrast-enhanced dual-energy CT data were collected from 31 patients with low-moderate differentiated gastric adenocarcinoma and 18 patients with gastric stromal tumor.Using VNC Software of Siemens Syngo Viewer Workstation,the iodine concentration (IC) of mixed iodine maps was measured.NIC of the lesions in arterial phase and portal phase and the abdominal aorta were calculated.The diagnostic efficiency of NIC in different phases for low-moderate differentiated gastric adenocarcinoma and gastric stromal tumor was analyzed. Results: In the iodine map,the blood supply of the low-moderate differentiated gastric adenocarcinoma in the portal phase was higher than that of the gastric stromal tumor,and the larger the gastric stromal tumor,the higher the heterogeneity.The NIC in portal phase of patients with low-moderate differentiated gastric adenocarcinoma was significantly higher than that of patients with gastric stromal tumor ( P <0.05).The receiver operating characteristic (ROC) curve showed that the sensitivity,specificity and area under the ROC curve of NIC in portal phase in the differential diagnosis of low-moderate differentiated gastric adenocarcinoma and gastric stromal tumor were 96.8%,50.0% and 0.713,respectively. Conclusion: Iodine map can directly reflect the blood supply.The NIC of dual source CT in the portal phase can differentiate low-moderate differentiated gastric adenocarcinoma from gastric stromal tumor.