能谱CT在结直肠癌分化程度中的应用价值研究

Aapplication value of spectral CT in the evaluation of the differentiation degree of colorectal cancer

目的:研究256排Revolution能谱CT各参数在结直肠癌分化程度中的应用价值。方法:选取50例通过肠镜或病理确诊的结直肠癌病人,于手术前行GSI能谱CT平扫及双期扫描,通过GSI Viewer软件获得相关能谱图像,并在病灶内勾画出合适的感兴趣区,测量病灶的碘基值(IC)、水浓度、有效原子序数(Eff-Z)、标准化碘浓度(NIC)及能谱曲线斜率(K)。根据病理结果,将50例病人分为低分化组与中高分化组,比较2组各能谱参数,并采用ROC曲线分析各能谱参数的诊断能力。结果:50例病人中高分化组32例,低分化组18例。低分化组肿瘤的淋巴结转移高于中高分化组(P<0.05)。2组动脉期IC、NIC、水浓度、Eff-Z、K及静脉期水浓度、Eff-Z差异均无统计学意义(P>0.05),低分化组静脉期IC、NIC、K均高于中高分化组(P<0.05)。静脉期IC、NIC、K诊断结直肠癌分化程度的曲线下面积分别为0.77、0.81、0.79,诊断阈值分别为18.31、0.56、2.07,敏感性分别为88.3%、83.3%、88.9%,特异性分别为62.5%、75.0%、68.7%。结论:能谱CT参数IC、NIC以及K在结直肠癌分化程度中有较高的应用价值。

Objective:To investigate the application value of each parameter of 256-row Revolution spectral CT in evaluating the differentiation degree of colorectal cancer.Methods:Fifty patients with colorectal cancer diagnosed by colonoscopy or pathology were selected,and detected using the GSI spectral CT plain scan and dual-phase scan before surgery.The relevant spectral images were obtained through GSI Viewer software,the appropriate region of interest was delineated in the lesion,and the iodine base value(IC),water concentration,effective atomic number(Eff-Z),normalized iodine concentration(NIC)and energy spectral slope(K)of the lesion were measured.According to the pathological results,50 patients were divided into the low differentiation group and middle-high differentiation group.The spectral parameters were compared between two groups,and the diagnostic ability of each spectral parameter were analyzed using the receiver operating characteristic curve.Results:Among 50 patients,32 cases in middle-high differentiation group and 18 cases in low differentiation group were identified.The lymph node metastasis in low differentiation group was higher than that in middle-high differentiation group(P<0.05).There was no statistical significance in the IC,NIC,water concentration,Eff-Z and K of arterial phase,and water concentration and Eff-Z of venous phase between two groups(P>0.05).The IC,NIC and K of venous phase in low differentiation group were higher than those in middle-high differentiation group(P<0.05).The area under the curve,diagnostic threshold,sensitivity and specificity of venous phase IC,NIC,and K were(0.77,0.81 and 0.79),(18.31,0.56 and 2.07),(88.3%,83.3%and 88.9%)and(62.5%,75.0%and 68.7%),respectively.Conclusions:The parameters IC,NIC and K of spectral CT have high values in evaluating the differentiation of colorectal cancer.