摘要
目的对比基于2D与3D双能CT(DECT)所测胃癌碘浓度(IC)预测其脉管侵犯(LVI)的价值。方法回顾性分析80例胃癌,其中39例存在LVI(LVI组)和41例无LVI(无LVI组);对比组间术前DECT表现,并以2D及3D方法分别于动脉期(AP)、静脉期(VP)及延迟期(DP)增强CT中测量肿瘤IC,分析2种方法所测IC值(2D IC与3D IC)的差异、一致性及相关性。采用多因素logistic回归分析针对组间差异有统计学意义的DECT参数筛选胃癌LVI的独立预测因子并构建联合模型,评估各单一DECT参数及联合模型预测胃癌LVI的效能。结果基于2D方法所测肿瘤IC均高于3D(P均<0.05)。2D所测肿瘤IC_(AP)与3D IC_(AP)、2D IC_(VP)与3D IC_(VP)、2D IC_(DP)与3D IC_(DP)一致性均较高且均呈高度正相关(r_(S)=0.839、0.834、0.830)。组间肿瘤厚度、临床T分期、CT淋巴结转移状态及2D IC_(AP)、2D IC_(VP)、2D IC_(DP)、3D IC_(VP)差异均有统计学意义(P均<0.05);临床T分期和2D IC_(DP)均为胃癌LVI的独立预测因子(P均<0.05)。以单一肿瘤厚度、临床T分期、CT淋巴结转移、2D IC_(AP)、2D IC_(VP)、2D IC_(DP)及3D IC_(VP)预测胃癌LVI的曲线下面积(AUC)为0.616~0.747,而联合模型的AUC更高(0.803,P均<0.05)。结论相比3D,基于DECT以2D方法测量胃癌IC对于预测LVI更具临床价值。
Objective To explore the value of iodine concentration(IC)of gastric cancer measured using 2D and 3D methods based on dual-energy CT(DECT)for predicting lymphovascular invasion(LVI).Methods Totally 80 cases of gastric cancer were retrospectively enrolled,including 39 cases with LVI(LVI group)and 41 cases without LVI(non-LVI group).Preoperative DECT manifestations of tumor were observed and compared between groups.Tumor IC were respectively measured in arterial phase(AP),venous phase(VP)and delayed phase(DP)enhanced CT using 2D and 3D methods,and the differences,consistency and correlation of results of 2D and 3D methods(2D IC and 3D IC)were analyzed.Then multivariate logistic regression analysis was performed for DECT parameters being significant different between groups to screen independent predictors of LVI of gastric cancer,and a combined model to construct.The efficacy of each single DECT parameter and the combined model for predicting LVI of gastric cancer were assessed.Results Tumors'2D IC were all higher than 3D IC(all P<0.05).The consistency of tumor’s 2D IC_(AP)and 3D IC_(AP),2D IC_(VP)and 3D IC_(VP),as well as 2D IC_(DP)and 3D IC_(DP)were all very high,also showed highly positive correlations(r_(S)=0.839,0.834,0.830).Significant differences of tumor thickness,clinical T stage,CT lymph node metastasis status,2D IC_(AP),2D IC_(VP),2D IC_(DP)and 3D IC_(VP)were found between groups(all P<0.05),and clinical T stage and 2D IC_(DP)of tumor were both independent predictors of LVI of gastric cancer(both P<0.05).The area under the curve(AUC)of tumor thickness,clinical T stage,CT lymph node metastasis,2D IC_(AP),2D IC_(VP),2D IC_(DP)and 3D IC_(VP)for predicting LVI of gastric cancer was 0.616 to 0.747,while of combined model was 0.803,higher than that of single DECT parameter(all P<0.05).Conclusion Compared with 3D method,IC of gastric cancer measured using 2D method based on DECT had better clinical value for predicting LVI.
作者
王健
贝天霞
林晓晓
姚晓强
陈望
李靖
WANG Jian;BEI Tianxia;LIN Xiaoxiao;YAO Xiaoqiang;CHEN Wang;LI Jing(Department of Radiology,the First Affiliated Hospital,College of Clinical Medicine of Henan University of Science&Technology,Luoyang 471003,China;Department of Radiology,Henan Cancer Hospital,Zhengzhou 450008,China)
出处
《中国医学影像技术》
北大核心
2026年第2期224-228,共5页
Chinese Journal of Medical Imaging Technology
基金
国家自然科学基金(82202146)
河南省科技发展计划(242102311173)
河南省医学科技攻关计划(SBGJ202402030)
河南省省级留学人员资助经费项目(HNLX202625)。
关键词
胃肿瘤
体层摄影术
X线计算机
脉管浸润
碘浓度
stomach neoplasms
tomography,X-ray computed
vascular invasion
iodine concentration
