摘要
目的探讨术前CT能谱成像在术前评估胃癌病理类型及分化程度方面的价值。方法回顾性分析91例胃癌患者肿块的能谱特征，所有患者术前均行CT单源双能能谱成像，测量病灶的碘、水浓度，并计算标准化后的碘浓度比。采用两独立样本t检验比较不同病理类型胃癌间的碘、水浓度差异，并与术后病理结果进行对照。结果人组患者胃癌术后病理证实为黏液癌24例和非黏液癌67例。胃非黏液癌患者静脉期碘浓度和碘浓度比分别为（21．33±6．31）×100μg/ml和0．55±0．17，均高于胃黏液癌患者的（16．94±6．13）×100μg／ml和0．42±0．14，差异均有统计学意义（t值分别为-2．948和-3．362，P值均〈0．01）；胃非黏液癌患者实质期碘浓度和碘浓度比分别为（20．65±5．49）×100μg/ml和0．72±0．20，均高于胃黏液癌患者的（18．07±4．51）×100μg/ml和0．57±0．12，差异均有统计学意义（t值分别为-2．261和-4．326，P值均〈0．05）。印戒细胞癌在静脉期和实质期的碘浓度、碘浓度比高于黏液腺癌，静脉期碘浓度分别为（19．36±4．75）×100和（12．10±5．92）×100μg/ml，碘浓度比分别为0．49±0．09和0．28±0．11；实质期碘浓度分别为（19．88±3．28）×100和（14．45±4．62）×100μg/ml，碘浓度比分别为0．63±0．08和0．47±0．11，差异均有统计学意义（t值分别为3．253、5．180、3．339、3．850，P值均〈0．01）。低分化腺癌在静脉期和实质期的碘浓度、碘浓度比均高于中高分化腺癌，静脉期碘浓度分别为（23．48±6．49）×100和（18．98±5．26）×100μg/ml，碘浓度比分别为0．61±0．16和0．48±0．15；实质期分别为（22．95±5．51）×100和（18．28±4．47）×100μg/ml，碘浓度比分别为0．81±0．21和0．63±0．15，差异均有统计学意义（t值分别为3．098、3．249、3．766、4．117，P值均〈0．01）。动脉期的水浓度、碘浓度、碘浓度比差异均无统计学意义（P值均〉0．05）。结论不同病理类型胃癌间的碘浓度不同，利用CT能谱成像获得的碘浓度有助于术前评估胃癌的病理类型。
Objective To evaluate spectral CT imaging in characterizing the pathological type and the differentiation of gastric cancer. Methods Ninety-one patients diagnosed of gastric cancer were retrospectively analyzed. Patients were all underwent triple-phase enhanced scan using single source dualenergy CT on gemstone spectral imaging（GSI） mode. Three types of images were reconstructed for analysis： the water concentration （ WC）, iodine concentration （ IC ）, and normalized iodine concentration （NIC）. The patients were divided into groups of mucinous carcinoma （ MUC）, including mucinous adenocarcinoma and signet ring cell carcinoma, and non-mucinous gastric carcinoma（non-MUC）. Independent-samples t test was used for statistical analysis. Results There were 24 patients of MUC and 67 patients of non-MUC. The IC and NIC of the non-MUC were significantly higher than the MUC in vein phase （VP） and in parenchymal phase （PP） [ （21.33 ± 6. 31 ） × 100 vs （ 16. 94 ± 6. 13） × 100 μg/ml,0. 55 ± 0. 17 vs 0.42 ± 0. 14 in VP, and（20. 65±5.49） × 100 vs （18.07 ±4. 51） × 100 μg/ml,0. 72 ±0. 20 vs 0. 57 ±0. 12 in PP,respectively t = - 2. 948, - 3. 362, - 2. 261, - 4. 326,P 〈 0. 053. The IC and NIC of the signet ring cell carcinoma were statistically higher than those of the mueinous adenocarcinoma [ （ 19. 36 ± 4.75 ）× 100 vs （ 12. 10 ±5.92）×100 μL/ml ,0. 49 ±0. 09 vs 0. 28±0.11 in VP,and （19.88±3.28）×100 vs （14.45±4.62）× 100μg/ml,0. 63 ±0. 08 vs 0. 47 ±0. 11 in PP,respeetively t =3. 253,5. 180,3. 339,3. 850,P 〈0. 01 ）. For Ihe poorly differenliated and well /moderately differenlialed adenocareinoma,the IC and NIC of tile former were higher than dmse of lhe latter in VP and PP [（23-48 ± 6. 49） × 100 vs （ 18.98 ± 5.26） × 100μg/ml, 0.61 ±0. 16 vs 0.48 ±0. 15 in VP,and （22.95 ± 5.51 ） × 100 vs （ 18.28 ±4.47） × 100 μg/ml,0. 81 ± 0. 21 vs 0. 63 ± 0. 15 in PP, respectively t = 3. 098,3. 249,3. 766,4. 117, P 〈 0. 01 ]. The between-group differenees of WC, IC and NIC in artery phase were no significant （ P 〉 0.05 ）. Conclusions Different pathological types couhl determine different IC. The spectral CT imaging may be helpful for characteriziug the pathological type of gastric cancer.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2013年第7期634-637,共4页
Chinese Journal of Radiology
