王博,谭红娜,王攀鸽,侯平,梁盼,高剑波.一站式CT能谱灌注成像预测兔腋窝淋巴结性质[J].中国医学影像技术,2019,35(2):175~180
一站式CT能谱灌注成像预测兔腋窝淋巴结性质
One-stop CT gemstone spectral and perfusion imaging for prediction in rabbit axillary lymph nodes
投稿时间:2018-05-06  修订日期:2018-09-29
DOI:10.13929/j.1003-3289.201805023
中文关键词:  腋窝淋巴结  肿瘤转移    体层摄影术,X线计算机  能谱成像  灌注成像
英文关键词:axillary lymph nodes  neoplasm metastasis  rabbits  tomography, X-ray computed  spectral imaging  perfusion imaging
基金项目:国家自然科学基金青年科学基金项目(81401378)。
作者单位E-mail
王博 郑州大学第一附属医院放射科, 河南 郑州 450052  
谭红娜 河南省人民医院放射科, 河南 郑州 450003  
王攀鸽 郑州大学第一附属医院放射科, 河南 郑州 450052  
侯平 郑州大学第一附属医院放射科, 河南 郑州 450052  
梁盼 郑州大学第一附属医院放射科, 河南 郑州 450052  
高剑波 郑州大学第一附属医院放射科, 河南 郑州 450052 cjr.gaojianbo@vip.163.com 
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中文摘要:
      目的 探讨一站式CT能谱灌注成像定量参数预测兔腋窝淋巴结性质的应用价值。方法 将60只新西兰纯种雌性大白兔随机分为2组,分别建立兔乳腺癌腋窝转移性淋巴结(转移组)与炎性淋巴结动物模型(炎症组)。于建模后第4周末对实验兔行一站式CT能谱灌注成像扫描,扫描完成后摘取腋窝淋巴结行病理检查,并与CT图像逐一对照。采用两独立样本t检验比较2组能谱参数和灌注参数的差异,以Logistic回归和ROC曲线分析单一参数和联合参数诊断实验兔腋窝淋巴结性质的效能。结果 转移组淋巴结的血流量(BF)、血容量(BV)、动静脉期碘浓度(IC)、标准化碘基值(NIC)和40~70 keV间的能谱曲线斜率(λ)均高于炎症组(P均<0.05),平均通过时间(MTT)和表面通透性(PS)差异无统计学意义(P均>0.05)。最佳联合参数(BF+动脉期λ+静脉期λ)的AUC为0.942,以0.65为临界值,其诊断实验兔腋窝乳腺癌转移性淋巴结的敏感度、特异度、阳性预测值和阴性预测值分别为79.68%、95.92%、92.91%和82.70%。结论 一站式CT能谱灌注成像定量参数鉴别兔腋窝乳腺癌转移性淋巴结与炎性淋巴结的诊断效能较好,联合参数(BF+动脉期λ+静脉期λ)具有较高诊断价值。
英文摘要:
      Objective To explore the application value of one-stop CT gemstone spectral and perfusion imaging quantitative parameters in predicting the properties of axillary lymph nodes. Methods Totally 60 purebred female New Zealand white rabbits were randomly divided into two groups, and rabbit models of axillary metastatic lymph nodes with VX2 implanted breast cancer (metastasis group) and inflammatory lymph nodes (inflammation group) were established, respectively. One-stop CT gemstone spectral and perfusion imaging scan was performed at the end of the fourth week after modeling. Then the axillary lymph nodes were taken for pathological examination and compared with CT images. Two independent samples t-test were used to compare the energy parameters and perfusion parameters between metastatic and inflammatory lymph nodes. Logistic regression and ROC curves were used to analyze the efficacy of single parameters and combined parameters in diagnosis of rabbit axillary lymph nodes. Results The blood flow (BF), blood volume (BV), arteriovenous iodine concentration (IC), standardized iodine value (NIC) and the slope (λ) of the energy spectrum curve from 40 keV to 70 keV in the metastasis group were higher than those in inflammation group (all P<0.05). There was no significant difference in mean transit time (MTT) and surface permeability (PS) between two groups (both P>0.05). Taken 0.65 as the threshold, AUC of combined parameters (BF+arterial phase λ+venous phase λ) was 0.942, the sensitivity, specificity, positive predictive value and negative predictive value in diagnosis of axillary lympy nodes were 79.68%, 95.92%, 92.91% and 82.70%, respectively. Conclusion The quantitative parameters of one-stop CT gemstone spectral and perfusion imaging show good diagnostic efficacy in identifying rabbit axillary breast cancer metastatic lymph nodes and inflammatory lymph nodes, while combined parameters (BF+arterial phase λ+venous phase λ) have higher diagnostic value.
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