双源CT双能量成像技术鉴别诊断结直肠癌转移性淋巴结与反应性增生淋巴结

目的 探讨双源CT双能量技术中碘含量及能谱成像在结直肠癌转移性淋巴结与反应性增生淋巴结鉴别诊断中的价值。方法 收集经手术病理证实、且具有完整资料的35例结肠直肠癌患者。将双源CT双能量扫描后动脉期100 kVp及Sn140 kVp两组薄层图像调入双能量工具软件中,选择"Liver VNC"模式测量结直肠癌原发病灶及腹部区域淋巴结碘含量;选取"Mono Energetic"模式对其能谱曲线进行分析。比较原发病灶、转移性淋巴结与反应性增生淋巴结碘含量及能谱曲线斜率的差异。结果 35例结直肠癌患者中,原发灶35个,共发现腹部区域淋巴结70枚,其中转移性淋巴结39枚,反应性增生淋巴结31枚。原发病灶与转移性淋巴结、反应性增生淋巴碘含量分别为(1.67±0.82)mg/ml、(1.55±0.99)mg/ml、(2.59±1.04)mg/ml,曲线斜率分别为0.72±0.41、0.71±0.16、0.48±0.10,三者碘含量及曲线斜率的差异均有统计学意义(P均<0.05);两两比较,仅原发病灶与转移性淋巴结间碘含量及曲线斜率的差异无统计学意义(P均>0.05)。结论 双源CT双能量扫描动脉期碘含量及能谱曲线斜率对结直肠癌转移性淋巴结及反应性增生淋巴结的鉴别诊断具有一定的价值。

Dual source CT dual-energy imaging technology in differential diagnosis of the metastatic and reactive hyperplastic lymph nodes in patients with colorectal cancer

Objective To explore the value of spectral imaging technique and iodine content of dual-energy CT in differential diagnosis of the reactive hyperplastic and metastatic lymph nodes in patients with colorectal cancer. Methods Totally 35 patients was pathologically confirmed as colorectal cancer and with complete information and underwent dual energy scan, and then the arterial thin layer images of 100 kVp and Sn 140 kVp were transferred to dual-energy software. The iodine content of the primary lesions and regional lymph nodes were measured in "Liver VNC" mode. The change trend of the spectrum curve were analyzed in "Mono Energetic" mode. The differences of iodine content and spectral curve were compared among primary lesion, metastatic lymph node and reactive hyperplastic lymph node. Results In 35 patients with colorectal cancer, 35 primary lesions and 70 regional lymph nodes were found, including 39 metastasis lymph nodes and 31 reactive hyperplastic lymph nodes. The iodine content of the primary lesions, the metastatic lymph nodes and the reactive hyperplastic were(1.67±0.82) mg/ml,(1.55±0.99) mg/ml and(2.59±1.04) mg/ml, respectively. The slope spectrum curve of the three lesion were difference, which were 0.72±0.41, 0.48±0.10 and 0.71±0.16, respectively. And the iodine content and the slope spectrum curve had statistical differences among this three kinds of lesions(P<0.05), while there were no statistical differences in the primary lesions and metastatic lymph nodes through pairwise comparison(P>0.05). Conclusion Dual-source CT dual-energy has a certain value in differential diagnosis of the reactive hyperplastic and metastatic lymph nodes in patients with colorectal cancer.