摘要
目的探讨能谱CT淋巴结短长径比和动脉期碘基值联合诊断胃癌淋巴结转移性的价值。方法将江苏省盐城市第一人民医院94例胃癌患者作为研究对象,均行腹部CT平扫与能谱增强扫描,淋巴结影像与病理结果均为一对一对照,记录淋巴结各参数的情况,并绘制受试者工作特征(ROC)曲线以分析各参数的诊断价值。结果胃癌转移性淋巴结的短径,短长径比,平扫和动、静脉期CT值与碘基值均明显高于非转移性淋巴结者(P<0.01);胃癌淋巴结短径,短长径比,平扫CT值,静脉期CT值、动脉期CT值及动、静脉期碘基值ROC的AUC分别为0.58、0.89、0.66、0.76、0.83、0.80、0.86,灵敏度分别为63.89%、80.06%、66.36%、65.09%、67.43%、71.94%、81.03%,特异度分别为43.96%、93.85%、51.53%、73.95%、89.03%、87.43%、83.75%;而短长径比和动脉期碘基值联合诊断ROC的AUC最大为0.94,敏感度为95.43%,特异度为80.54%。结论能谱CT淋巴结短长径比和动脉期碘基值联合诊断胃癌淋巴结转移性具有较高的灵敏度,二者联合诊断的价值较高。
Objective To analyze the value of combined the ratio of short to long diameter with arterial iodine value in diagnosing the lymph node metastasis of gastric cancer in spectral computed tomography(CT).Methods A total of 94 patients with gastric cancer in Yancheng City No.1 People′s Hospital were selected,all the patients underwent abdominal CT scan and energy spectrum enhanced scan.The lymph node images and pathological results were one-to-one compared,the parameters of lymph node were recorded,and the ROC curves were drew to analyze the diagnostic value of parameters.Results The short diameter,the ratio of short to long diameter,plain and arteriovenous CT value and venous phase of iodine value in the metastatic lymph node were significantly higher than those in the non-metastatic lymph nodes(P<0.01);the AUCs of ROCs in lymph node short diameter,the ratio of short to long diameter,plain CT value,venous CT value,arterial CT value,venous iodine value,arterial iodine value were 0.58,0.89,0.66,0.76,0.83,0.80 and 0.86,respectively;the sensitivities were 63.89%,80.06%,66.36%,65.09%,67.43%,71.94%and 81.03%,respectively;the specificities were 43.96%,93.85%,51.53%,73.95%,89.03%,87.43%and 83.75%,respectively;the AUC of ROC for combined diagnosis value in the ratio of short to long diameter with arterial iodine value was 0.94,with the sensitivity of 95.43%,and the specificity of 80.54%.Conclusion Combined the ratio of short to long diameter with arterial iodine value by spectral CT for diagnosis of lymph node metastasis in gastric cancer has higher sensitivity and diagnostic value.
作者
张益兰
史讯
许凤
ZHANG Yilan;SHI Xun;XU Feng(Institute of Medical Imaging,Jiangsu Vocational College of Medicine,Yancheng, Jiangsu 224007,China;Department of Radiology,Yancheng City No.1 People′s Hospital,Yancheng, Jiangsu 224000,China;Institute of Extended Education,Jiangsu Vocational College of Medicine,Yancheng,Jiangsu 224007,China)
出处
《重庆医学》
CAS
2018年第32期4156-4159,共4页
Chongqing medicine
基金
江苏省盐城市科学技术局支持项目(YK2016057)
关键词
能谱CT成像
胃癌
淋巴结转移
短长径比
动脉期碘基值
Spectral CT imaging
Gastric cancer
Lymph node metastasis
Ratio of short to long diameter
Arterial iodine value
