能谱CT参数对非小细胞肺癌淋巴结转移的定性评估价值

Qualitative evaluation value of energy spectrum CT parameters for lymph node metastasis in non-small cell lung cancer

目的探讨能谱CT参数对非小细胞肺癌淋巴结转移情况的定性评估价值。方法收集行胸部能谱CT增强检查的57例非小细胞肺癌患者的临床资料,共获得淋巴结148枚,其中,转移性淋巴结66枚(转移组),非转移性淋巴结82枚(未转移组)。所有患者均行能谱CT中的宝石CT能谱成像(GSI)模式进行双期(动静脉期)增强扫描,分析能谱参数[动静脉期碘密度值(IC)、水密度值(WC)、能谱曲线斜率(λHU)、标准化碘密度值(NIC)、标准化水密度值(NWC)、标化有效原子序数(Neff-Z)]对非小细胞肺癌淋巴结转移情况的定性评估价值。结果转移组动静脉期能谱CT参数中的IC、NIC、λHU、Neff-Z均明显低于未转移组(P﹤0.01)。受试者工作特征(ROC)曲线分析结果显示,动脉期能谱CT参数中λHU、IC、NIC、Neff-Z的AUC分别为0.79(95%CI:0.72~0.86)、0.73(95%CI:0.64~0.82)、0.85(95%CI:0.77~0.92)、0.71(95%CI:0.63~0.79)。静脉期能谱CT参数中λHU、IC、NIC、Neff-Z的AUC分别为0.81(95%CI:0.73~0.88)、0.84(95%CI:0.77~0.90)、0.86(95%CI:0.79~0.93)、0.74(95%CI:0.69~0.82)。结论术前能谱CT参数对非小细胞肺癌淋巴结转移情况具有一定的定性评估价值,有利于术前明确淋巴结转移的状态。

Objective To investigate the qualitative evaluation value of energy spectrum CT parameters for lymph nodes metastasis in non-small cell lung cancer.Method A total of 57 patients with non-small cell lung cancer who received enhanced chest energy spectrum CT were selected and 148 lymph nodes were obtained,including 66 metastatic lymph nodes(metastatic group)and 82 non-metastatic lymph nodes(non-metastatic group).All patients were scanned by dual phase(arterial and venous phase)enhanced scanning with gemstone spectral imaging(GSI)mode in energy spectrum CT.The energy spectrum parameters were iodine concentration(IC)value and water concentration(WC)value of arterial and venous phase.The slope of spectral HU curve of arterial and venous phase(λHU),normalized iodine concentration(NIC)value,normalized water concentration(NWC)value and normalized effective-Z(Neff-Z)were calculated.Analyze the qualitative evaluation value of energy spectrum parameters for non-small cell lung cancer lymph node metastasis.Result The IC,NIC,λHU and Neff-Z values of the CT parameters of the arterial and venous phase in the metastatic group were significantly lower than those in the non-metastatic group(P<0.01).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)values of arterial phase energy spectrum CT parametersλHU,IC,NIC and Neff-Z were 0.79(95%CI:0.72-0.86),0.73(95%CI:0.64-0.82),0.85(95%CI:0.77-0.92)and 0.71(95%CI:0.63-0.79),respectively;the AUC values of venous phase were 0.81(95%CI:0.73-0.88),0.84(95%CI:0.77-0.90),0.86(95%CI:0.79-0.93)and 0.74(95%CI:0.69-0.82),respectively.Conclusion The preoperative energy spectrum CT parameters have moderate value in the qualitative evaluation of lymph node metastasis of non-small cell lung cancer,which is helpful to determine the status of lymph node metastasis before operation.