摘要
目的观察光谱CT预测结直肠癌(CRC)区域淋巴结转移的价值。方法回顾性分析73例经术后病理证实CRC患者,根据区域淋巴结转移与否分为阳性组(n=29)和阴性组(n=44);基于静脉期光谱CT图像获取淋巴结短径、120 kV常规图像CT值(CT值_(120 kV))、40 keV和70 keV虚拟单能量图像CT值(CT值_(40 keV)和CT值_(70 keV))、碘密度(ID)、有效原子序数(Zeff)及能谱曲线斜率(λHU),比较组间上述参数及临床指标差异;排除方差膨胀因子>10者后,分别基于糖类抗原19-9(CA19-9)和癌胚抗原(CEA)构建模型1,基于普通CT参数(淋巴结短径、CT值_(120 kV))构建模型2,基于光谱CT参数(CT值_(70 keV)、ID、Zeff、λ_(HU))构建模型3,基于普通CT参数及光谱CT参数构建模型4;分析四者预测CRC区域淋巴结转移的效能。结果组间患者性别、CA19-9、CEA、淋巴结短径、CT值_(120 kV)、CT值_(40 keV)、CT值_(70 keV)、ID、Zeff及λ_(HU)差异均有统计学意义(P均<0.05)。模型1~4预测CRC区域淋巴结转移的曲线下面积(AUC)分别为0.734、0.752、0.996及0.995;其中,模型1与模型3、4,模型2与模型3、4间AUC差异均有统计学意义(P均<0.001)。结论基于增强静脉期光谱CT可有效预测CRC区域淋巴结转移。
Objective To observe the value of spectral CT for predicting regional lymph node metastasis of colorectal cancer(CRC).Methods Totally 73 patients with CRC confirmed by postoperative pathology were retrospectively enrolled and divided into positive group(n=29)and negative group(n=44)based on the presence or absence of regional lymph node metastasis.The lymph node short diameter,CT value of 120 kV conventional image(CT_(value 120 kV)),CT values of 40 keV and 70 keV virtual single energy images(CT_(value 40 keV)and CT_(value 70 keV)),iodine density(ID),effective atomic number(Zeff)and spectral curve slope(λ_(HU)).The above parameters and clinical indicators were compared between groups.After excluding those with variance inflation factor greater than 10,model 1 was constructed based on carbohydrate antigen 19-9(CA19-9)and carcinoembryonic antigen(CEA),model 2 based on conventional CT parameters(lymph node short diameter,CT_(value 120 kV)),model 3 based on spectral CT parameters(CT_(value 70 keV),ID,Zeff,λ_(HU)),and model 4 based on conventional CT parameters and spectral CT parameters.The efficacy of 4 models for predicting regional lymph node metastasis of CRC were analyzed.Results Significant differences in patients'gender,carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA),lymph node short diameter,CT_(value 120 kV),CT_(value 40 keV),CT_(value 70 keV),ID,Zeff andλ_(HU)were found between 2 groups(all P<0.05).The area under the curve(AUC)of model 1—4 for predicting regional lymph node metastasis of CRC was 0.734,0.752,0.996 and 0.995,respectively,and significant differences were found between model 1 and 3,model 1 and 4,model 2 and 3,as well as model 2 and 4(all P<0.001).Conclusion Enhanced venous phase spectral CT could effectively predict regional lymph node metastasis of CRC.
作者
卓水清
刘雅丹
江琳玲
郑舒文
符劲
刘立志
ZHUO Shuiqing;LIU Yadan;JIANG Linling;ZHENG Shuwen;FU Jin;LIU Lizhi(Department of Radiology,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Guangdong Provincial Clinical Research Center for Cancer,Guangzhou 510060,China)
出处
《中国医学影像技术》
CSCD
北大核心
2024年第9期1366-1370,共5页
Chinese Journal of Medical Imaging Technology
