增强CT值及双源CT评估胃腺癌病理分化的价值

Value of enhanced CT and dual-energy CT in evaluating pathological differentiation of gastric adenocarcinoma

目的:探讨双源平扫及增强CT参数评估胃腺癌病理分化程度的价值。方法:回顾性分析2018年10月—2020年1月在我院行双源CT扫描并经病理证实胃腺癌患者113例,同期选择43例健康人群为正常组。胃腺癌组患者根据肿瘤分化程度将患者分为高、中、低分化组,比较各组之间CT参数水平(K、NIC、碘浓度与有效原子序数)及增强CT值的差异进行比较。结果:胃腺癌组患者K值、NIC值均高于正常组,碘浓度、有效原子序数低于正常组(P<0.05);K、NIC、碘浓度、有效原子序数的AUC值为0.667、0.657、0.513、0.633;高分化组患者K值、NIC均低于中、低分化组,碘浓度、有效原子序数均高于中、低分化组(P<0.05);高分化组门静脉期CT值低于中、低分化组患者(P<0.05)。结论:双源CT参数与增强CT值对胃腺癌恶性程度判断有较高价值。

Objective:To investigate the value of enhanced CT and dual-energy CT in evaluating pathological differentiation of gastric adenocarcinoma.Methods:113 patients with gastric adenocarcinoma who underwent dual-energy CT scan and pathology examinations in our hospital from October 2018 to January 2020 were retrospectively analyzed.Patients were divided into three groups according to the pathological results:high differentiation group,moderate differentiation group and low differentiation group.Meanwhile,another 43 normal individuals were set as normal group.Parameters(K,NIC,iodine concentration and effective atomic number)and the enhanced CT values were compared among groups.Results:K value and NIC value of gastric adenocarcinoma group were higher than those of normal group,and the iodine concentration and effective atomic number were lower than those of normal group(P<0.05).AUC values of K,NIC,iodine concentration,and effective atomic number were 0.667,0.657,0.513 and 0.633;K value and NIC of high differentiation group were lower than those of moderate and low differentiation groups,and the iodine concentration and effective atomic number were higher than those of moderate and low differentiation groups(P<0.05).The CT value of portal venous phase of high differentiation group were lower than those of moderate and low differentiation groups(P<0.05).Conclusion:Enhanced CT and dual-energy CT are meaningful in evaluating pathological differentiation of gastric adenocarcinoma.