宝石能谱CT诊断胃癌区域淋巴结转移的临床应用价值

摘要

Objective To investigate the clinical value of gemstone spectral CT in the diagnosis of regional lymph node metastasis of gastric cancer.Methods One hundred patients with gastric cancer were scanned by spiral CT first and then gemstone spectral CT one hour later.The clinical value of gemstone spectral CT in the diagnosis of lymph node metastasis of gastric cancer were evaluated by comparison of diagnostic power of spiral CT and gemstone spectral CT.Results The sensitivity of gemstone spectral CT in the diagnosis of lymph node metastasis of gastric cancer was 91.2％,the specificity was 90.0％,and the diagnostic coincidence rate was 91.0％.The sensitivity of spiral CT was 76.3％,the specificity was 55.0％,and the diagnostic coincidence rate was 72.0％.When the length of metastatic lymph node was longer than 8 mm and enhancement difference greater than 80 Hu,gemstone spectral CT had higher consistency with the pathological results (κ value:0.842 and 0.856).Conclusion The gemstone spectral CT had high diagnostic rate of lymph node metastasis in gastric cancer.The length of lymph nodes ≥ 8 nun and enhancement of lymph node ≥ 80 Hu could be regarded as lymph node metastasis positive.%目的 探讨宝石能谱CT诊断胃癌区域淋巴结转移的临床应用价值.方法 选取100例胃癌患者,患者术前先经螺旋CT扫描,间隔1个小时后,经宝石能谱CT扫描.观察并记录两组患者宝石能谱CT诊断结果及螺旋CT诊断结果,宝石能谱CT上淋巴结长径和淋巴结强化程度不同的诊断结果,评价宝石能谱CT诊断胃癌区域淋巴结转移的诊断效果.结果 宝石能谱CT诊断胃癌淋巴结转移的敏感度为91.2％(73/80),特异度为90.0％ (18/20),诊断符合率91.0％ (91/100),螺旋CT诊断胃癌淋巴结转移的敏感度为76.3％ (61/80),特异度为55.0％(11/20),诊断符合率72.0％ (72/100),当转移性淋巴结长径≥8mm时,与病理诊断结果一致性较高(κ值0.842).当强化程度差值≥80 Hu时,与病理诊断结果一致性较高(κ值0.856).结论 宝石能谱CT对胃癌转移性淋巴结具有较高的诊断率,特异性和敏感度较高,以淋巴结长径≥8mm及淋巴结强化密度差值≥80 Hu为诊断淋巴结转移阳性的标准,能提高判断淋巴结是否转移的准确性.