本文選題：胃腫瘤　切入點：體層攝影術　出處：《中華臨床醫(yī)師雜志(電子版)》2016年23期 　論文類型：期刊論文

【摘要】：目的探討單源雙能CT碘基圖對早期胃癌(EGC)的診斷價值。方法回顧性分析27例經手術病理證實為EGC的患者資料,所有患者均于術前行單源雙能CT能譜成像(GSI)模式三期動態(tài)增強掃描,對三期增強圖像進行碘-水配對基物質分離獲得碘基圖,并經后處理生成各期碘偽彩圖(IPCM)。由兩位觀察者依據手術記錄所示病灶位置對三期IPCM病灶檢出情況進行評分,對評分結果的一致性進行Kappa檢驗,并計算各期病灶檢出率,采用卡方檢驗比較。由兩位觀察者分別測量各期IPCM中病灶、正常胃壁以及同層主動脈的碘濃度,對兩位觀察者測量結果的一致性進行組內相關系數(ICC)檢驗,并計算病灶和正常胃壁的標準化碘濃度(NIC),采用配對樣本t檢驗比較各期IPCM中病灶和正常胃壁NIC間的差異。結果兩位觀察者對各期IPCM病灶檢出的評分結果一致性均很好(Kappa0.80),動脈期、靜脈期及平衡期IPCM對病灶的檢出率分別為81.48%、55.56%及14.81%,各期之間檢出率比較均有統(tǒng)計學意義(P0.05)。兩位觀察者對各期IPCM中病灶、正常胃壁以及同層主動脈碘濃度測量結果的一致性均很好(ICC0.75),動脈期、靜脈期及平衡期IPCM的病灶和正常胃壁的NIC分別為0.14±0.04和0.08±0.03,0.42±0.12和0.32±0.10,0.44±0.10和0.42±0.11,動脈期和靜脈期病灶與正常胃壁NIC間差異均有統(tǒng)計學意義(t值分別為11.425和6.240,均P0.05),平衡期病灶與正常胃壁NIC間差異無統(tǒng)計學意義(t=2.007,P=0.055)。結論單源雙能CT碘基圖可以定量診斷EGC,動脈期IPCM對EGC的檢出率高,具有較大臨床價值。
[Abstract]:Objective to evaluate the diagnostic value of single source and dual energy CT iodide base imaging in early gastric carcinoma. Methods 27 cases of EGC proved by surgery and pathology were retrospectively analyzed. All patients underwent three phase dynamic enhanced scanning with single source and dual energy CT energy dispersive imaging (GSI) mode before operation. Iodine base images were obtained by separating iodine and water pairings from three phase enhanced images. After post-processing, the iodine pseudochromogram of each phase was generated. According to the location of the lesion recorded by the operation, the detection of the third stage of IPCM was evaluated by two observers, the consistency of the scoring results was tested by Kappa, and the detection rate of each stage of the lesion was calculated. The iodine concentrations of lesions, normal gastric wall and aorta in each stage of IPCM were measured by chi-square test. The consistency of the measured results of the two observers was tested by intragroup correlation coefficient (ICC). The standard iodine concentration of the lesion and normal gastric wall was calculated and the difference between the lesion and the normal gastric wall NIC in each stage of IPCM was compared by paired t-test. Results the results of the two observers' scores for each stage of IPCM were consistent very well, the arterial phase was 0.80%. The detectable rates of IPCM in venous phase and equilibrium phase were 55.56% and 14.81%, respectively. The consistency of measurement results of iodine concentration in normal gastric wall and aorta of the same layer was very good. The NIC of IPCM and normal gastric wall were 0.14 鹵0.04 and 0.08 鹵0.03 鹵0.42 鹵0.12 and 0.32 鹵0.10 鹵0.44 鹵0.10 and 0.42 鹵0.11, respectively. The difference of NIC in arterial phase and venous phase was 11.425 and 6.240, respectively (P < 0.05). There was no significant difference between NIC in normal gastric wall and there was no significant difference between them. Conclusion single source and dual energy CT iodide base imaging can be used to quantitatively diagnose EGC, and the detection rate of IPCM in arterial phase is high. It has great clinical value.
【作者單位】： 大連醫(yī)科大學附屬第一醫(yī)院放射科;
【分類號】：R735.2;R730.44

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