Objective To investigate the value of dual-layer spectral detector CT energy spectrum images in the detec-tion and staging of cervical cancer.Methods Forty-eight patients with first diagnosis of cervical cancer were collected,all of whom underwent spectral CT and pelvic magnetic resonance imaging with complete histopathological data.Spectral CT 40 keV and MRI images were analyzed by 2 senior imaging physicians in a double-blind method to record whether they were positive lesions,to observe tumor site,size and extent in multiple planes for positive lesions,to determine the presence of pa-rametrial infiltration,vaginal infiltration and lymph node metastasis,and to evaluate the staging.The x2 test was used to an-alyze and compare the differences between the above-mentioned groups of parameters.The most obvious area of lesion in-tensification in both arterial and venous stages was selected,the ROI of lesion and iliac artery was outlined,iodine density(IC)was recorded,and standardized iodine density(NIC)was calculated,and the differences between the two quantitative parameters of early stage(≤stage ⅡA)and progressive stage(≥stage Ⅱ B)of cervical cancer were compared using in-dependent sample t-test.ROC curves were drawn to analyze the IC and NIC in diagnosing early stage and progressive stage of cervical cancer.The effectiveness of IC and NIC in diagnosing early stage and progressive stage of cervical cancer was analyzed.Results The detection rates of MRI and spectral CT for cervical cancer were higher than those of conventional CT,with 91.67％(44/48),81.25％(39/48)and 60.42％(29/48),respectively,and the differences were statistically significant.The diagnostic compliance rate of spectral CT for cervical cancer stage Ⅱ B and above(100.00％)was higher than that of MRI(95.65％),and the difference was not statistically significant.The diagnostic compliance rate of MRI for cervical cancer stage ⅠB1 and below and stage Ⅰ B2-Ⅱ A(80.00％and 90.00％)was higher than that of spectral CT(20.00％and 75.00％),and the difference was not statistically significant.The sensitivity,specificity and accuracy of spectral CT in diagnosing lymph node metastasis of cervical cancer(90.00％,100.00％,94.87％)were higher than those of MRI(65.00％,87.50％,77.27％),and the differences were statistically significant.The IC and NIC in both arterial and venous stages of cervical cancer progression were higher than those in early stages,and the differences between IC and NIC in arterial stage were statistically significant.the ROC curve showed that the area under the curve(AUC)of NIC in arterial stage diagnosing early and progressive cervical cancer was 0.718(95％CI:0.552-0.850),which was higher than that of IC in arterial stage 0.704(95％CI:0.536～0.839),and the difference was not statistically significant(Z=0.382,P＞0.05),and the arterial phase NIC was better diagnosed.Conclusion Spectral CT can optimally display cervical canc-er lesions and their infiltration extent,and has advantages in evaluating lymph node metastasis.Arterial stage IC and NIC have certain diagnostic value in differentiating cervical cancer in early stage from progressive stage.
NETL
NSTL
维普
万方数据
