| 唐琪,谢东,苏丹柯,罗宁斌,金观桥,廖成成,王铮,覃云英.能谱CT定量参数鉴别诊断原发性胃淋巴瘤和胃癌[J].中国医学影像技术,2017,33(2):221~226 |
| 能谱CT定量参数鉴别诊断原发性胃淋巴瘤和胃癌 |
| Dual-energy spectral CT quantiative parameters in differential diagnosis of primary gastric lymphoma and gastric carcinoma |
| 投稿时间：2016-08-09 修订日期：2016-11-04 |
| DOI：10.13929/j.1003-3089.201608039 |
| 中文关键词: 淋巴瘤 胃肿瘤 体层摄影术,X线计算机 能谱成像 |
| 英文关键词:Lymphoma Stomach neoplasms Tomography,X-ray computed Spectral imaging |
| 基金项目:广西医疗卫生适宜技术研究与开发课题（S201417-06）；广西研究生教育创新计划（YCBZ2014029）。 |
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| 中文摘要: |
| 目的 探讨能谱CT（GSI）定量参数鉴别诊断原发性胃淋巴瘤（PGL）和胃癌（GC）的价值。方法 收集PGL患者16例（PGL组）、GC患者24例（GC组），行平扫和GSI双期增强扫描。测量两组肿瘤病灶的单能量CT值、碘（水）基物质浓度和有效原子序数（Zeff），计算标化碘浓度（NIC）、能谱曲线斜率（λHU）、标化原子序数（Zeff-c）。采用独立样本t检验对各定量参数进行比较分析，运用ROC曲线评估其诊断效能。结果 PGL组增强双期40~90 keV图像λHU均低于GC组（t=2.90、3.69，P=0.008、0.001）。PGL组动脉期40 keV、静脉期40~120 keV单能量CT值均低于GC组（P均<0.05）；PGL组70 keV增强双期NIC、动脉期标化水浓度均低于GC组，PGL组静脉期Zeff-c高于GC组（P均<0.05）；静脉期70 keV单能量图像以λHU=2.63 mg/cm3为阈值鉴别诊断PGL和PC的敏感度和特异度分别为62.5%和100%。结论 GSI定量参数对PGL和GC的鉴别诊断有一定实用价值。 |
| 英文摘要: |
| Objective To investigate the value of spectral CT quantitative parameters in differential diagnosis of primary gastric lymphoma (PGL) and gastric carcinoma (GC).Methods Sixteen patients with PGL (PGL group) and twenty-four patients with GC (GC group) were enrolled. All patients underwent plain and two phases enhanced spectral CT scans. The monochromatic CT values, iodine (water) concentration and effective atomic number (Zeff) of the two groups were measured, and the parameterized values (Zeff) and the slope of the spectral Hounsfield unit curve (λHU) were calculated in two phases, respectively. The spectral characteristic parameters listed above were quantitative analyzed by two-samples t test. The diagnostic efficacies were evaluated by ROC analysis.Results During both arterial and venous phases,λHU on 40-90 keV monochromatic images was lower in PGL group than that in GC group (t=2.90, 3.69; P=0.008, 0.001). In both arterial phase on 40 keV and venous phase on 40-120 keV monochromatic images, the CT values in PGL group were significantly lower than those in GC group (all P<0.05). On 70 keV monochromatic images, the normalized iodine concerntration on enhanced dual-phase and the normalized water concerntration in arterial phase were lower in PGL group than those in GC group (all P<0.05). However, Zeff-c in venous phase was higher in PGL group than that in GC group (P<0.05). The best single parameter for differential diagnosis of PGL and GC was λHU on 70 keV monochromatic images, and taking λHU=2.63 mg/cm3 as threshold values, the sensitivity and specificity were 62.5% and 100%, respectively.Conclusion Quantitative assessment with gemstone spectral imaging quantitiative parameters is practical in differential diagnosis of PGL and GC. |
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