Objective:To investigate the value of spectral CT multi-parameters in the preopera-tive prediction of perineural invasion(PNI)in colorectal cancer(CRC).Methods:The clinical and ima-ging data of 123 CRC patients from March 2021 to May 2023 were retrospectively analyzed.Among them,71 cases were identified as PNI and 52 cases as non-PNI(nPNI).All CRC patients underwent whole-abdomen triple phase enhanced spectral CT examination before surgery.Iodine concentration(IC),normalized IC(nIC)and slope of the spectral curve(λH)at triple-phase contrast enhanced scan-ning were measured,and the tumor extracellular volume fraction(ECV)was calculated.The diffe-rences in each parameter were compared between the PNI group and the nPNI group.Parameters with statistically significant difference were included in binary logistic regression analyses to construct a combined prediction model,and effectiveness of differential diagnosis of each parameter and the com-bined model for differentiating between PNI and nPNI was tested by the receiver operating characte-ristic(ROC)curves.Results:The measured values of IC and λH on triple-phase enhanced images,and NIC and ECV on venous and delayed phase images in the PNI group were greater than those in the nPNI group,and the differences were statistically significant(P＜0.05),whereas the difference be-tween arterial phase nIC was not statistically significant between the two groups(P＞0.05).The area under the curve(AUC)of the single parameter for predicting PNI status was 0.632～0.820,the AUC of the combined model for predicting PNI status was 0.859,with sensitivity and specificity of 76.10％and 86.50％,respectively.Conclusion:Spectral CT multi-parameters were able to predict preoperatively PNI in CRC,which is expected to promote further research and long-term clinical application of spec-tral CT in preoperative prediction of CRC-PNI.
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