| 王祥发.基于双能量CT定量参数的胃淋巴瘤与胃癌鉴别诊断研究[J].安徽医药,待发表. |
| 基于双能量CT定量参数的胃淋巴瘤与胃癌鉴别诊断研究 |
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| 投稿时间：2025-03-29 录用日期：2025-04-30 |
| DOI： |
| 中文关键词: 原发性胃淋巴瘤 进展期胃癌 双能量CT 鉴别诊断 |
| 英文关键词: |
| 基金项目:基金资助项目名称:双能量CT多功能成像联合HP预测HER-2突变型胃癌治疗效果及预后 |
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| 中文摘要: |
| 目的 探讨双能量CT(DECT)定量参数对原发性胃淋巴瘤(PGL)与进展期胃癌(AGC)的鉴别诊断价值。方法 回顾性分析经病理证实的50例PGL患者(PGL组)及70例AGC(AGC组)患者的临床及DECT资料,测量胃壁厚度、浆膜面侵犯、动静脉期的标准化碘浓度(NICAP、NICVP)及能谱曲线斜率(λAP、λVP),分析以上参数在两组的差异,对有统计学意义的参数建立Logistic回归模型并建立联合模型,运用受试者工作特征曲线(ROC曲线)评价各参数诊断效能。结果 PGL组与AGC组的胃壁厚度分别为17.54±7.93(mm)、14.98±3.91(mm)；NICAP值分别为0.17±0.03、0.19±0.01；NICVP值分别为0.38±0.07、0.65±0.28；λAP分别为1.61±0.40、1.93±0.78；λVP分别为1.98±0.40、2.88±0.76。胃壁厚度、NICAP差异无统计学意义(P＞0.05)。胃浆膜面侵犯有统计学意义(P＝0.044)。λAP、NICVP、λVP差异有统计学意义(P＜0.05)。λAP、NICVP、λVP鉴别诊断PGL与AGC的ROC曲线下面积(AUC)分别为0.636、0.813、0.869,将双期参数联合胃浆膜侵犯后AUC为0.976,敏感性为92.2%,特异性为86.2%。结论 PGL与AGC的DECT碘定量参数(NICVP、λAP、λVP)存在差异,且AGC组各值均高于PGL组,利用双能量CT成像有助于PGL与AGC术前鉴别诊断,可将DECT参数联合胃浆膜面侵犯诊断PGL及AGC,以提高诊断敏感性和特异性。 |
| 英文摘要: |
| Objective:To investigate the diagnostic value of dual-energy CT (DECT) quantitative parameters in differentiating primary gastric lymphoma (PGL) from advanced gastric cancer (AGC).MethodsThis retrospective study analyzed clinical and DECT data from 50 pathologically confirmed PGL patients (PGL group) and 70 AGC patients (AGC group). Parameters including gastric wall thickness, serosal invasion, normalized iodine concentration in arterial and venous phases (NICAP, NICVP), and spectral curve slope (λAP, λVP) were measured. Differences in these parameters between the two groups were evaluated. Statistically significant parameters were incorporated into logistic regression models, including a combined model. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis.ResultsGastric wall thickness in PGL and AGC groups was 17.54 ± 7.93 mm and 14.98 ± 3.91 mm, respectively. NICAP values were 0.17 ± 0.03 (PGL) vs. 0.19 ± 0.01 (AGC), NICVP: 0.38 ± 0.07 vs. 0.65 ± 0.28, λAP: 1.61 ± 0.40 vs. 1.93 ± 0.78, and λVP: 1.98 ± 0.40 vs. 2.88 ± 0.76. No significant differences were observed in gastric wall thickness (P > 0.05) or NICAP (P > 0.05). Serosal invasion showed statistical significance (P = 0.044). Significant differences were identified in λAP, NICVP, and λVP (all P < 0.05). The areas under the ROC curve (AUC) for λAP, NICVP, and λVP in discriminating PGL from AGC were 0.636, 0.813, and 0.869, respectively. Combining dual-phase parameters with serosal invasion achieved an AUC of 0.976, with sensitivity of 92.2% and specificity of 86.2%.ConclusionDECT-derived iodine quantification parameters (NICVP, λAP, λVP) demonstrate significant differences between PGL and AGC, with higher values observed in AGC. DECT imaging facilitates preoperative differentiation between PGL and AGC. The combination of DECT parameters with serosal invasion improves diagnostic sensitivity and specificity, offering enhanced clinical utility. |
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