能谱CT容积碘含量对晚期胃癌化疗效果的评价

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摘要目的：分析晚期胃癌化疗前后能谱CT成像参数的变化特点，探讨客观评价疗效的评估指标及预测指标。方法：连续收集52例经胃镜病理确诊为晚期胃癌的患者，化疗前后行能谱CT成像。测量化疗前后病灶的最长径、最大厚度、最大截面积、体积及动静脉期的标准化碘值、容积碘含量，并计算各参数的变化率。按照RECIST1.1标准分为有效组和无效组。采用Mann-Whitney U检验比较各参数。结果：化疗后，有效组各参数值均明显降低（P＜0.05），以动静脉期容积碘含量变化率最大；其最大厚度变化率、最大横截面积变化率、体积变化率及动静脉期容积碘含量变化率均明显大于无效组（P＜0.01）。化疗前有效组最大厚度明显大于无效组（P=0.036）。结论：能谱CT静脉期容积碘含量的变化有可能成为新的疗效评估指标，结合病灶形态学信息能够为临床化疗疗效做出有效评价。

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	陈丽芳
	傅钢泽
	黄定品
	满意
	金尹
	董千铜
	黄颖宝
	陈勇春
	王宏清

关键词 ：能谱, 体层摄影术, X线计算机, 容积碘含量, 晚期胃癌, 疗效评价

Abstract：Objective: To explore parameters for the objective evaluation and prediction of chemotherapy efficiency by characterizing the imaging parameters of dual-energy CT scanning before and after chemotherapy in patients with advanced gastric cancer. Methods: Fifty-two patients with advanced gastric cancer confirmed by gastroscopy and pathology were collected consecutively. Dual-energy enhanced CT scanning was performed before and after chemotherapy to obtain the morphological and functional parameters of the tumors, including maximum diameter, maximum thickness, maximum cross-sectional area, volume, standardized iodine value in both artery and venous phases and volume iodine content. The changes of each parameter were also calculated. According to RECIST1.1 criteria, patients were divided into chemotherapy effective group and chemotherapy ineffective group. Mann-whitney U was used to compare parameters. Results: After chemotherapy, all values of the parameters in the chemotherapy effective group were significantly decreased (P<0.05), with the change of volume iodine content in artery and venous phase being the most significant. Changes in maximum thickness, maximum cross-sectional area, volume and iodine content in artery and venous phases in chemotherapy effective group were significantly higher than those in the ineffective group (P<0.01). Before chemotherapy, the maximum thickness in the effective group was significantly higher than that in the ineffective group (P=0.036). Conclusion: The changes of volume iodine content in venous phase by dual-energy CT might be a new parameter for the evaluation of chemotherapy efficiency, and together with morphological parameters, it may provide an accurate prediction for the chemotherapy effect on the advanced gastric cancer.

Key words： dual-energy tomography, X-ray computed volumetric iodine content advanced gastric cancer chemotherapy efficiency

收稿日期: 2018-06-02

基金资助:温州市公益性科技计划项目（Y20170222）。

作者简介: 陈丽芳（1988-），女，浙江瑞安人，住院医师。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I12/898

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