能谱CT多模态参数联合临床参数对胃间质瘤Ki-67的预测价值

  目的  探索能谱CT多模态参数联合临床特征参数对胃间质瘤（GST）Ki-67的预测价值。  方法  回顾性分析2019年9月~2022年4月我院34例GST患者，依照其术后免疫组化Ki-67的百分比将患者进行分组，其中Ki-67≥6%为高表达组（n=15）；Ki-67的百分比 < 6% 为低表达组（n=19）。行双源能谱CT扫描，测量及收集70 keV CT值、标准化碘浓度、能谱曲线斜率及临床特征等参数，并对上述数据与GST Ki-67表达进行相关性分析。  结果  直径、年龄与GST Ki-67高低表达组具有相关性（P < 0.05）。GST Ki-67低表达组的静脉期、延迟期能谱斜率值组内具有一定差异性（ICC < 0.75），其余各组参数组内差异性较小（ICC > 0.75）。除延迟期能谱斜率值组间差异无统计学意义（P > 0.05），其余各组参数组间差异均有统计学意义（P < 0.05）。动静脉期70 keV CT值、三期NIC、动脉期能谱斜率与GST的Ki-67表达呈正相关关系（P < 0.05）；延迟期70 keV CT值、静脉期能谱曲线斜率与GST的Ki-67表达呈负相关关系（P < 0.05）。动静脉期70 keV CT值、三期NIC、动脉期能谱斜率预测GST的Ki-67表达的效果较好，其中静脉期NIC的AUC值最高为0.984。  结论  三期70 keV CT值、NIC值、动静脉期能谱斜率及直径、年龄在预测GST Ki-67表达中具有一定的价值。 

Predictive value of energy spectrum CT multimodal parameters combined with clinical parameters in gastric stromal tumor Ki-67

  Objective  To explore the predictive value of energy spectrum CT multimodal parameters combined with clinical characteristic parameters for gastric stromal tumor (GST) Ki-67.  Methods  Thirty-four patients with gastric stromal tumor in our hospital who met the inclusion criteria from September 19 to February 22, 2019 were retrospectively analyzed. The patients were divided into groups according to the percentage of Ki-67 in postoperative immunohistochemistry. Ki-67 percentage ≥6% was high expression group (n=15), and Ki-67 < 6% was low expression group (n=19). Dual-source CT scan was performed to measure and collect 70 keV CT value, standardized iodine concentration, energy spectrum curve slope and clinical characteristics, and the correlation between the above data and the expression of Ki-67 in gastric stromal tumor was analyzed.  Results  The correlation between diameter, age and GST Ki-67 expression was significant (P < 0.05). The lag period NIC value and energy spectrum slope of GST Ki-67 low expression group had some differences within the group (ICC < 0.75), and the other parameters had small differences within the group (ICC > 0.75). Except for the energy spectrum slope value of delay period, there were no significant differences between groups (P > 0.05), other parameters were significantly different between groups (P < 0.05). Ki-67 expression in GST was positively correlated with 70keVCT value in arteriovenous phase, NIC in arterial phase and energy spectrum slope (P < 0.05). Ki-67 expression of GST was negatively correlated with 70 keV CT value in delayed period and slope of energy spectrum curve in venous period (P < 0.05). The expression of Ki-67 in GST was predicted by 70 keV CT value of arteriovenous phase, NIC of phase iii and energy spectrum slope of arterial phase, and the highest AUC value of NIC in venous phase was 0.984.  Conclusion  The three-phase 70 keV CT value, NIC value, energy spectrum slope and diameter of arteriovenous phase and age have certain value in predicting the expression of GST Ki-67.