双源CT能量成像在评估非小细胞肺癌纵隔淋巴结转移中的应用价值

Value of dual-source CT energy imaging in evaluating mediastinal lymph node metastasis in non-small cell lung cancer

目的应用双源CT(DSCT)能量成像分析非小细胞肺癌(NSCLC)纵隔转移淋巴结与非转移淋巴结能谱参数及能谱曲线的差异,探讨DSCT标准化碘浓度及能谱曲线与纵隔淋巴结转移之间的关系。方法对113例NSCLC患者行DSCT能量成像扫描,在处理工作站得到碘图图像,测量所有入组纵隔淋巴结的标准化碘浓度以及在不同能量水平下的能谱曲线。根据病理结果分为转移淋巴结组与非转移淋巴结组,两组淋巴结标准化碘浓度及能谱曲线斜率采用t检验分析,通过受试者工作特征曲线(ROC)计算标准化碘浓度诊断NSCLC纵隔淋巴结转移的最佳阈值。结果NSCLC两组纵隔淋巴结动脉期及静脉期的标准化碘浓度差异有统计学意义(P<0.05);应用ROC曲线计算出标准化碘浓度诊断NSCLC纵隔淋巴结转移的最佳阈值为52.45%;NSCLC两组纵隔淋巴结的能谱曲线为逐渐下降型曲线,两组在40~110 keV区间下CT值差异有统计学意义(P<0.05)。结论运用DSCT能量成像的参数进行定量分析,对NSCLC纵隔淋巴结转移的诊断意义较大;可作为术前判断NSCLC淋巴结转移重要指标之一。

Objective Dual-source CT(DSCT)energy imaging was used to analyze the difference of energy spectrum parameters and energy spectrum curves between mediastinal metastatic lymph nodes and non-metastatic lymph nodes in non-small cell lung cancer(NSCLC).The relationship between DSCT standardized iodine concentration and energy spectrum curve with mediastinal lymph node metastasis was discussed.Methods A total of 113 patients with NSCLC underwent DSCT energy imaging scans.Iodine images were obtained at the processing workstation.The normalized iodine concentrations of all mediastinal lymph nodes and energy spectrum curves at different energy levels were measured.According to the pathological results,the patients were divided into lymph node metastasis group and non-lymph node metastasis group.The normalized iodine concentration and energy spectrum curve slope of the two groups were analyzed by t-test.The best threshold of standardized working iodine concentration was calculated by receiver operating characteristic curve(ROC)to diagnose the mediastinal lymph node metastasis of NSCLC.Results There was a significant difference in the normalized iodine concentration between the two groups of mediastinal lymph nodes in NSCLC(P<0.05);The ROC curve was used to calculate the standardized iodine concentration for the diagnosis of NSCLC.The optimal threshold for lymph node metastasis was 52.45%;The energy spectrum curve of mediastinal lymph nodes in NSCLC was gradually decreasing.There was a significant difference between the two groups in the range of 40~110 keV interval(P<0.05).Conclusion The quantitative analysis of DSCT energy imaging parameters is of great significance in the diagnosis of mediastinal lymph node metastasis in NSCLC.It can be used as an important index for preoperative judgment of lymph node metastasis in NSCLC.