摘要
目的：探讨宝石能谱CT在胃的癌前病变及早期胃癌诊断中的应用。方法：回顾性分析26例行宝石能谱CT扫描检测的早期胃癌及胃的癌前病变患者,其均经胃镜及手术病理证实,其中早期胃癌14例,高级别上皮内瘤变6例,低级别上皮内瘤变6例。通过GSI能谱的后处理重建,产生单光子能量水平（40~140 keV）的图像,对结果行单因素方差分析。结果：早期胃癌与正常胃壁组织的101单能量图像动脉期40、50、60、70 keV及碘的基础物质值和门脉期40、50、60、70、80 keV及有效单能量能谱值、碘的基础物质值差异均有统计学意义（P〈0.05）。早期胃癌与低级别上皮内瘤变组织间,40~140 keV的101单能量图像动脉期40、50 keV单能量能谱值差异有统计学意义（P〈0.05）;而早期胃癌与高级别上皮内瘤变组织间,40~140 keV的101单能量图像中水、碘的基础物质值差异无统计学意义。高级别上皮内瘤变与低级别上皮内瘤变、高级别上皮内瘤变与正常胃壁组织、低级别上皮内瘤变与正常胃壁组织之间,各值差异无统计学意义。结论：宝石能谱CT在胃的癌前病变及早期胃癌的诊断中可提供定量诊断分析。
Objective To study the use of CT gemstone spectral imaging in the diagnosis of gastric pre-cancerous lesion and early gastric cancer.Methods Twenty-six patients（16 male and 10 female,mean age 60 years,ranged from 26-84 years） with 14 early gastric cancer,6 high grade intraepithelial neoplasia（HGIEN） and 6 low grade intraepithelial neoplasia（LGIEN） were scanned by Discovery CT750HD Gemstone Spectral Imaging（GSI）.One-way analysis of variance was performed for analyzing the resulting parameters,and P0.05 was considered as significant.Also,two radiologists assessed the lesion with conventional imaging characteristics.Results There was a statistically significant difference between early gastric cancer and normal gastric wall tissue in 40-140keV 101 monoenergetic images： arterial phase 40keV,50keV,60keV,70keV,material value based water and iodine and portal phase 40keV,50keV,60keV,70keV,80keV,effective monoenergetic spectrum value,material value based iodine.Significant differences were seen in 40-140keV 101 monoenergetic images： arterial phase 40keV,50keV monoenergetic spectrum value between early gastric cancer and low grade intraepithelial neoplasia.No significant difference in 40-140keV 101 monoenergetic images： material value based water and iodine was found between early gastric cancer and high grade intraepithelial neoplasia.There was no significant difference between early gastric cancer and high grade intraepithelial neoplasia,high grade intraepithelial neoplasia and low grade intraepithelial neoplasia,low grade intraepithelial neoplasia and normal gastric tissues（P0.05）.Conclusions CT Gemstone Spectral Imaging could provide additional imaging information that may improve the differentiation of gastric pre-cancerous lesion and early gastric cancer.
出处
《诊断学理论与实践》
2011年第5期428-433,共6页
Journal of Diagnostics Concepts & Practice
关键词
早期胃癌
胃癌前病变
宝石能谱计算机断层扫描
鉴别诊断
Early gastric cancer
Gastric pre-cancerous lesions
Computer tomograph Gemstone Spectral Imaging
Differential diagnosis
