文献类型：期刊文献

中文题名：光谱CT量化的细胞外容积评估结直肠癌神经、血管及淋巴管浸润

英文题名：Extracellular Volume Quantified by Spectral CT to Assess Neurovascular and Lymphatic Infiltration in Patient with Colorectal Cancer

作者：郑文霞[1];王莉莉[2];陈杏彪[4];郑小霞[1];崔雅琼[1];马颖[1];魏照坤[2];梁小芹[3];黄刚[2]

第一作者：郑文霞

机构：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000;[2]甘肃省人民医院放射科,甘肃兰州730000;[3]甘肃省人民医院病理科,甘肃兰州730000;[4]飞利浦医疗临床科研部,上海200070

第一机构：甘肃中医药大学临床医学院

年份：2022

卷号：30

期号：9

起止页码：896

中文期刊名：中国医学影像学杂志

外文期刊名：Chinese Journal of Medical Imaging

收录：CSTPCD;;北大核心:【北大核心2020】；CSCD:【CSCD2021_2022】；

基金：甘肃省青年基金计划项目(20JR5RA143)。

语种：中文

中文关键词：光谱CT;结直肠癌;碘密度;细胞外容积;神经及血管淋巴管浸润

外文关键词：Spectral CT;Colorectal cancer;Iodine density;Extracellular volume;Nerve and vascular lymphatic infiltration

摘要：目的探讨基于双层探测器光谱CT碘密度测量的细胞外容积(ECV)评估结直肠癌神经、血管及淋巴管浸润的可行性及诊断效能。资料与方法回顾性纳入2020年7月—2021年2月于甘肃省人民医院诊断为结直肠癌的95例(结肠癌22例,直肠癌73例)患者的基本资料,所有患者行双层探测器光谱CT增强检查,检查前均采集红细胞压积,扫描后测量病灶及正常肠壁的静脉期、延迟期碘密度及同层面腹主动脉或髂血管碘密度,计算ECV;以术后病理结果为“金标准”,对病理切片疑有血管、淋巴管内癌栓及神经侵犯者行免疫组化染色。利用受试者工作特征曲线分析ECV术前诊断结直肠癌神经、血管及淋巴管浸润的效能。结果血管侵犯阳性组40例,阴性组55例;淋巴管侵犯阳性组37例,阴性组58例,神经侵犯阳性组51例,阴性组44例。神经、血管、淋巴管浸润阳性组及阴性组静脉期ECV比较,差异均无统计学意义(t=1.641、1.646、1.543,P均>0.05)。神经、血管、淋巴管浸润阳性组及阴性组间延迟期ECV比较,差异均有统计学意义(t=4.663、5.806、6.663,P均<0.001)。静脉期、延迟期结直肠癌的ECV与正常肠壁相比差异均有统计学意义(t=16.561、17.317,P均<0.001)。静脉期、延迟期ECV对于免疫组化的AUC分别为:血管侵犯0.576、0.798,淋巴管侵犯0.575、0.838;神经侵犯0.584、0.759。结论基于双层探测器光谱CT延迟期碘密度量化的ECV分数可反映结直肠癌患者的神经、血管及淋巴管浸润情况,为临床提供一种新的术前评估方法。
Purpose To evaluate the feasibility and diagnostic efficacy of extracellular volume(ECV)based on iodine density measurement with dual-layer spectral detector CT for evaluating nerve and vascular lymphatic infiltration in patient with colorectal cancer.Materials and Methods A total of 95 patients diagnosed with colorectal cancer from July 2020 to February 2021 in Gansu Provincial Hospital were retrospectively collected,including colon cancer patients(n=22)and rectal cancer patients(n=73).All patients underwent enhancement scanning via dual-layer spectral detector CT.Hematocrit was collected before scanning,and iodine density at the venous phase and the delayed phase of the lesion and the normal intestinal wall was measured after scanning,respectively,at the lesion level of the abdominal aorta or iliac vessels to calculate ECV scores.Using postoperative pathological results as the gold standard,immunohistochemical staining was used for patients with suspected vascular or lymphatic tumor thrombus and nerve invasion.Receiver operating characteristic curve was performed to analyze the ECV efficacy of preoperative diagnosis of nerve and vascular lymphatic infiltration in patients with colorectal cancer.Results There were 40 cases with vascular invasion in positive group and 55 cases in negative group.There were 37 cases with lymphatic vessel invasion in positive group,58 cases in negative group,and 51 cases with nerve invasion in positive group,44 cases in negative group.There was no statistical difference in ECV at the venous phase between the positive group and the negative group of vascular,lymphatic vessel and nerve invasion,respectively(t=1.641,1.646 and 1.543,all P>0.05).There were significant differences in ECV at the delayed phase between the positive group and the negative group of vascular,lymphatic vessel and nerve invasion,respectively(t=4.663,5.806 and 6.663,all P<0.001).ECV of colorectal cancer group at the venous and delayed phases were all significantly increased than that of normal intestinal wall,respectively(t=16.561,17.317,all P<0.001).The area under the curve of ECV at the venous and delayed phase of vascular,lymphatic vessel and nerve invasion was 0.576,0.798;0.575,0.838;0.584,0.759,respectively.Conclusion ECV score based on dual-layer spectral detector CT delayed iodine density measurement can reflect nerve and vascular lymphatic infiltration in patients with colorectal cancer,providing a new method for clinical preoperative evaluation.