不同病理级别喉及下咽鳞癌的能谱参数研究

目的：探讨不同病理级别喉及下咽鳞癌(LHSCC)双能量能谱 CT(DECT)成像能谱参数的差异,为判断 LHSCC 预后提供帮助。方法回顾性分析经病理证实 LHSCC 并治疗前行 DECT 扫描的患者61例,扫描后数据在工作站分析,获取病变部位碘基物质浓度(IC)、水基物质浓度(WC)、能谱曲线斜率(s-SHC)。按细胞分化程度将患者分为高、中、低分化组,比较不同组间 IC、WC、s-SHC、T 分期构成比的差异。结果不同分化组间 IC、s-SHC 差异均有统计学意义(F =3.56,3.96,P <0.05)；两两比较表明低、高分化组 IC、s-SHC 差异均有统计学意义(P <0.05),低、中分化组和中、高分化组 IC、s-SHC 差异无统计学意义(P >0.05)；WC 值差异均无统计学意义(H =0.84,P >0.05)；T 分期构成比差异无统计学意义(P >0.05)。结论能谱参数中 IC、s-SHC 有助于判断 LHSCC 的病理分级,可能对其预后评估有一定帮助。

Spectral parameters analysis of pathologic differentiation of laryngeal and hypopharyngeal squamous cell carcinoma

Objective To evaluate the discrepancy of parameters generated on dual-energy spectral CT (DECT)imaging in the different pathological grade of laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC),and to provide helpful information of the prognosis and the guide of clinical treatment.Methods 61 patients with pathologically confirmed LHSCC who underwent contrastenhanced DECT before therapy were retrospectively analyzed.The enhanced monochromatic data were analyzed with workstation.Iodine concentration of lesion (IC),water concentration of lesion (WC)and slope of spectral HU curve (s-SHC)were acquired.According to cell differentiation,all patients were divided into well,moderately and poorly differentiated groups.The difference of IC,WC,s-SHC,constituent ratio of T stage were compared among different groups.Results The IC and s-SHC had significant difference among well,moderately and poorly differentiated groups(F =3.56,3.96 respectively,P <0.05).The two-two paired comparisons demonstrated that there were significant difference of IC between poorly and well differentiated group(P <0.05).The others two-two paired comparisons demonstrated no significant difference (P>0.05).There were no significant difference of WC among three groups respectively (H =0.84,P >0.05).χ2 test showed that there was no significant difference for the constituent ratio of T stage among three groups (P >0.05).Conclusion IC and s-SHC can help to judge the pathological grade of LHSCC,and they may be useful to evaluate the prognosis of LHSCC.