光谱CT细胞外容积在结肠癌分化程度中的应用研究
The Application Research of Spectral CT Extracellular Volume in the Differentiation Degree of Colorectal Cancer
王艺洁 1赵卫 1凌冰冰 1杨亚英 1田扬1
作者信息
- 1. 650032 昆明医科大学第一附属医院医学影像科
- 折叠
摘要
目的 探索双层探测器光谱CT(DLCT)细胞外容积(ECV)在定量评估结肠癌分化程度中的价值.方法 回顾性搜集经DLCT检查的结肠癌患者106例,根据术后病理检查结果将患者分为高级别组24例(低分化及黏液腺癌)、低级别组82例(中分化、高分化),比较不同分级肿瘤三期增强扫描的碘浓度(IC)、标准化碘浓度(NIC)、有效原子序数(Zeff)、ECV(％)的差异,构建联合参数并对差异有统计学意义的指标绘制受试者工作特征(ROC)曲线,Delong检验比较各参数之间的差异.结果 静脉期IC、Zeff以及延迟期Zeff、IC、NIC、ECV与结肠癌分化程度具有显著相关性,高级别组结肠癌的各参数值均大于低级别组,延迟期定量参数分别为Zeff(8.357±0.192 vs.8.135±0.251)、IC(1.988±0.394 mg/ml vs.1.527±0.324 mg/ml)、NIC(0.566±0.103 vs.0.432±0.080)、ECV[(35.019±6.132)％vs.(26.484±4.873)％],且上述差异均具有统计学意义(均P＜0.05).在所有单一参数中,延迟期ECV(％)具有较高的诊断效能,受试者工作特征曲线曲线下面积(AUC)为0.865,约登指数为0.626,诊断阈值为30.330％时,敏感度为83.33％、特异度为79.27％.并且延迟期ECV(％)的AUC高于静脉期IC和Zeff,差异均有统计学意义(均P＜0.05),延迟期联合参数AUC略高于ECV(％),但差异无统计学意义.结论 DLCT的延迟期ECV值在结肠癌分化程度中具有较高的诊断价值.
Abstract
Objective This study aims to investigate the value of extracellular volume(ECV)in quantitatively assess-ing the differentiation degree of colon cancer using dual-layer spectral CT(DLCT).Methods 106 cases of colon cancer patients who underwent DLCT examination were retrospectively collected.According to the postoperative pathological exami-nation results,the patients were divided into a high-grade group of 24 cases(poorly differentiated and mucinous adenocar-cinoma)and a low-grade group of 82 cases(moderately differentiated and highly differentiated).The differences in iodine concentration(IC),normalized iodine concentration(NIC),effective atomic number(Z-effective,Zeff),and ECV(％)of tumors at different grades were compared.Joint parameters were constructed,and ROC(Receiver Operating Characteris-tic,ROC)curves were plotted for indicators with statistically significant differences.The Delong test was used to compare the differences between various parameters.Results During the venous phase,IC,Zeff,and delayed-phase Zeff,IC,NIC,and delayed-phase ECV(％)showed significant correlations with the differentiation degree of colon cancer.The val-ues of these parameters were higher in the high-grade group compared to the low-grade group.The quantitative parameters during the delayed phase were as follows:Zeff(8.357±0.192 vs.8.13±0.251),IC(1.988±0.394 mg/ml vs.1.527±0.324 mg/ml),NIC(0.566±0.103 vs.0.432±0.080),and ECV(35.019±6.132％vs.26.484±4.873％).All these differences were statistically significant(all P＜0.05).Among all parameters,delayed-phase ECV(％)showed higher diagnostic performance,with an AUC of 0.865 and a Youden index of 0.626.When the diagnostic threshold was set at 30.33％,the sensitivity was 83.33％and the specificity was 79.27％,and the AUC of delayed-phase ECV(％)is higher than that of venous-phase IC and Zeff,and the differences are statistically significant(both P＜0.05),the delayed-phase combined parameter AUC is slightly higher than ECV(％),but the difference is not statistically significant.Con-clusion The ECV based on DLCT has high diagnostic value in assessing the differentiation degree of colon cancer.
关键词
结肠癌/光谱CT/细胞外基质/细胞外容积/分化程度/病理分级Key words
Colon cancer/Spectral CT/Extracellular matrix/Extracellular volume/Differentiation degree/Patho-logical grading引用本文复制引用
基金项目
云南省放射与治疗临床医学研究中心专项基金项目(202102AA100067)
云南省科技厅科技计划项目(202101AY070001-104)
出版年
2024
NETL
NSTL
万方数据