CT灌注扫描参数与直肠癌患者临床病理特征以及预后的关系

Relationship between CT perfusion parameters and clinicopathological features and prognosis of rectal cancer patients

目的探讨直肠癌患者CT灌注扫描参数与临床病理特征以及预后的关系。方法选取2020年9月至2021年9月于运城市中心医院影像科接诊的80例高度疑似直肠癌患者,均给予CT灌注成像检查,将手术病理诊断结果作为本次研究的金标准,计算CT灌注成像诊断准确率、灵敏度及特异度,Kappa检验CT灌注成像与金标准的一致性。比较直肠癌、良性直肠肿瘤患者CT灌注参数,比较不同病理特征直肠癌患者CT灌注参数,随访1年,比较存活组、死亡组CT灌注参数。结果CT灌注成像诊断准确率是96.25%,灵敏度是97.22%,特异度是87.50%,Kappa检验CT灌注成像与手术病理诊断的一致性较好(Kappa值=0.791)。直肠癌组达到峰值时间(TTP)、平均通过时间(MTT)均短于良性直肠肿瘤组,差异有统计学意义(P<0.05);直肠癌组血流量(BF)、血容量(BV)均高于良性直肠肿瘤组,差异有统计学意义(P<0.05)。Ⅲ期组TTP、MTT均长于Ⅱ期组、Ⅰ期组,差异有统计学意义(P<0.05);Ⅲ期组BF、BV均低于Ⅱ期组、Ⅰ期组,差异有统计学意义(P<0.05);有淋巴结转移组TTP、MTT均长于无淋巴结转移组,差异有统计学意义(P<0.05);有淋巴结转移组BF、BV均低于无淋巴结转移组,差异有统计学意义(P<0.05)。死亡组TTP、MTT均短于存活组,差异有统计学意义(P<0.05);死亡组BF、BV均高于存活组,差异有统计学意义(P<0.05)。结论CT灌注成像可提高直肠癌诊断准确率、灵敏度及特异度,CT灌注参数还可以反映肿瘤病灶的血流动力学变化,在病灶性质判断及预后评估中具有重要参考价值。

Objective To investigate the relationship between CT perfusion parameters and clinicopathological features and prognosis of rectal cancer patients.Methods A total of 80 patients with highly suspected rectal cancer admitted to the Department of Imaging of Yuncheng Central Hospital from September 2020 to September 2021 were selected,and all patients underwent CT perfusion imaging.The surgical pathological diagnosis results were used as the gold standard of this study.The diagnostic accuracy,sensitivity and specificity of CT perfusion imaging were calculated,and Kappa test was used to test the consistency between CT perfusion imaging and the gold standard.The CT perfusion parameters of patients with rectal cancer and benign rectal tumor were compared,and the CT perfusion parameters of patients with rectal cancer with different pathological characteristics were compared.After 1 year of follow-up,the CT perfusion parameters of the survival group and the death group were compared.Results The diagnostic accuracy of CT perfusion imaging was 96.25%,the sensitivity was 97.22%,and the specificity was 87.50%.The Kappa test showed that the consistency between CT perfusion imaging and surgical pathological diagnosis was good(Kappa value=0.791).The time to peak(TTP)and mean transit time(MTT)in rectal cancer group were shorter than those in benign rectal tumor group,and the differences were statistically significant(P<0.05).The blood flow(BF)and blood volume(BV)of rectal cancer group were higher than those of benign rectal tumor group,and the difference was statistically significant(P<0.05).TTP and MTT in stageⅢgroup were longer than those in stageⅡgroup and stageⅠgroup,and the differences were statistically significant(P<0.05).The BF and BV of stageⅢgroup were lower than those of stageⅡgroup and stageⅠgroup,and the differences were statistically significant(P<0.05).TTP and MTT in the lymph node metastasis group were longer than those in the non-lymph node metastasis group,and the differences were statistically significant(P<0.05).BF and BV in the group with lymph node metastasis were lower than those in the group without lymph node metastasis,and the differences were statistically significant(P<0.05).TTP and MTT in the death group were lower than those in the survival group,and the differences were statistically significant(P<0.05).The BF and BV of the death group were higher than those of the survival group,and the differences were statistically significant(P<0.05).Conclusion CT perfusion imaging can improve the diagnostic accuracy,sensitivity and specificity of rectal cancer.CT perfusion parameters can also reflect the hemodynamic changes of tumor lesions,which has important reference value in the judgment of lesion nature and prognosis evaluation.