| 尤亚茹,刘译阳,袁梦晨,赵帅,李莉明,陈俣菘,郑月,高剑波.能谱CT定量参数评估进展期胃癌T分期[J].中国医学影像技术,2024,40(11):1704~1709 |
| 能谱CT定量参数评估进展期胃癌T分期 |
| Spectral CT quantitative parameters for evaluating T stage of advanced gastric cancer |
| 投稿时间：2024-06-17 修订日期：2024-08-28 |
| DOI：10.13929/j.issn.1003-3289.2024.11.015 |
| 中文关键词: 胃肿瘤 肿瘤分期 体层摄影术,X线计算机 |
| 英文关键词:stomach neoplasms neoplasm staging tomography, X-ray computed |
| 基金项目:河南省医学科技攻关计划项目(LHGJ20220409)。 |
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| 中文摘要: |
| 目的 观察能谱CT多参数成像评估进展期胃癌(AGC) T分期的价值。方法 纳入155例AGC患者,根据术后病理分为T2组(n=40)及T3/4a组(n=115)。测量术前能谱CT图像动静脉期40~140 keV单能级图像中AGC病灶CT值、水浓度(WC)及碘浓度(IC),计算标准化IC (nIC)、能谱曲线斜率k1和k2。比较组间临床指标及能谱定量参数,绘制受试者工作特征曲线,计算曲线下面积(AUC),评估各指标/模型及联合模型鉴别T2期与T3/4a期AGC的价值。结果 T3/4a组肿瘤厚度、低分化程度占比,以及动、静脉期CT100 keV值、CT140 keV值及WC均高于T2组(P均＜0.05)。单静脉期CT140 keV值为鉴别效能最高的单一参数,其AUC为0.782。临床-动静脉期模型的AUC为0.848,高于单一临床模型及动脉期模型(P均＜0.05)而与静脉期模型差异无统计学意义(P＞0.05)。结论 利用AGC能谱CT定量参数、尤其静脉期参数可有效评估其T分期;多参数联合模型诊断价值更高。 |
| 英文摘要: |
| Objective To observe the value of spectral CT parameters for evaluating T staging of advanced gastric cancer (AGC). Methods Totally 155 AGC patients were collected and divided into T2 stage (n=40) and T3/4a stage (n=115) according to postoperative pathology. CT values, water concentration (WC) and iodine concentration (IC) of AGC lesions on 40—140 keV arteriovenous phase single energy level images were measured, and the standardized IC (nIC) and spectral curve slopes k1 and k2 were calculated. Clinical variables and spectral quantitative parameters were compared between groups, and receiver operating characteristic curve was plotted, the area under the curve (AUC) was calculated to evaluate the value of each parameter and model for identifying T2 and T3/4a stage AGC. Results Tumor thickness, proportion of low differentiation degree, CT100 keV, CT140 keV, and WC values in T3/4a group were all significantly higher than those in T2 group (all P＜0.05). CT140 keV of AGC lesions on venous phase images presented the highest discrimination efficacy among single parameters, with AUC of 0.782. AUC of clinical-arterial phase-venous phase model was 0.848, higher than that of clinical model and arterial phase model alone (both P＜0.05) but not significantly different compared with AUC of venous phase model (P＞0.05). Conclusion Spectral CT quantitative parameters, especially venous phase parameters could be used to effectively identify T stage of AGC. Multi-parameter combined models had higher diagnostic value. |
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