| 王祥发,宋芹霞,史恒峰,等.基于双能量 CT定量参数的原发性胃淋巴瘤与进展期胃癌鉴别诊断研究[J].安徽医药,2026,30(6):1194-1197. |
| 基于双能量 CT定量参数的原发性胃淋巴瘤与进展期胃癌鉴别诊断研究 |
| Differential diagnosis of primary gastric lymphoma and advanced gastric cancer based on quantitative parameters of dual-energy CT |
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| DOI：10.3969/j.issn.1009-6469.2026.06.026 |
| 中文关键词: 胃肿瘤 双能量 CT 标准化碘浓度 能谱曲线斜率 鉴别诊断 淋巴瘤 双、P，组，， |
| 英文关键词: Gastric neoplasm Dual-energy computed tomography Normalized iodine concentration Spectral curve slope Diagnostic differentiation Lymphoma |
| 基金项目:安庆市医疗卫生类自筹经费科技计划项目( 2023Z1004，2025Z2001) |
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| 中文摘要: |
| 目的探讨双能量 CT(DECT)定量参数对原发性胃淋巴瘤( PGL)与进展期胃癌( AGC)的鉴别诊断价值。方法回顾性分析安徽医科大学安庆医学中心 2022年 8月至 2024年 12月收治且经病理证实的 50例 PGL病人( PGL组)及 70例 AGC(AGC组)病人的临床及 DECT资料，测量胃壁厚度、浆膜面侵犯、动静脉期的标准化碘浓度( NICAPNICVP)及能谱曲线斜率( λAP、λVP)，分析以上参数在两组的差异，对差异有统计学意义的参数建立 logistic回归模型并建立联合模、型，运用受试者操作特征曲线(ROC曲线)评价各参数诊断效能。结果 PGL组与 AGC组的胃壁厚度分别为( 17.54±7.93)mm、(14.98±3.91)mm；NICAP值分别为 0.17±0.03、0.19±0.01；NICVP值分别为 0.38±0.07、0.65±0.28；λAP分别为 1.61±0.40、1.93±0.78；λVP分别为 1.98±0.40、2.88±0.76。两组胃壁厚度、 NICAP均差异无统计学意义(均 P>0.05)λAPNICVPλVP、胃浆膜面侵犯均差异有统计学意义(均 P<0.05)。 λAPNICVPλVP鉴别诊断PGL与AGC的ROC曲线下面积(AUC，)及、其95%、CI分别为 0.64(0.55，0.72)、 0.81(0.74，0.88)、 0.87(0.81，0.93)期参数( NICVP、λAP、λVP)联合胃浆膜面侵犯后 AUC及其 95%CI为 0.98(0.95，1.00)灵敏度为 92.2%，特异度为 86.2%。结论 GL与 AGC的 DECT碘定量参数(NICVP、λAP、λVP)存在差异，且 AGC组各值均高于 PGL利用 DECT成像有助于 PGL与 AGC术前鉴别诊断，可将 DECT参数联合胃浆膜面侵犯诊断 PGL及 AGC，以提高诊断灵敏度和特异度。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of dual-energy CT (DECT) quantitative parameters in differentiating prima. ry gastric lymphoma (PGL) from advanced gastric cancer (AGC).Methods Clinical and DECT data of 50 PGL patients (PGL group)and 70 AGC patients (AGC group), who were admitted to Anqing Medical Center of Anhui Medical University from August 2022 to De.cember 2024 and pathologically confirmed, were analyzed retrospectively. Parameters measured including gastric wall thickness, sero.sal invasion, normalized iodine concentration in arterial (NICAP) and venous phases ( NICVP), and spectral curve slope in arterials (λAP)and venous phases (λVP). Differences in these parameters between the two groups were evaluated. Statistically significant parameterswere incorporated into logistic regression models to build a combined model. Diagnostic performance was assessed by using receiver op.erating characteristic curve (ROC curve) analysis.Results Gastric wall thickness in PGL and AGC groups was (17.54±7.93) mm and (14.98±3.91) mm. NICAP values were 0.17±0.03 in the PGL group and 0.19±0.01 in the AGC group; NICVP values were 0.38±0.07 and 0.65±0.28; λAP values were 1.61±0.40 and 1.93±0.78; and λVP values were 1.98±0.40 and 2.88±0.76, respectively. There was no signifi. cant difference in gastric wall thickness and NICAP between the two groups (all P>0.05). There were significant differences in λAP,NICVP, λVP and serosal invasion (all P<0.05). The area under the ROC curve (AUC) and 95% CI for λAP, NICVP, and λVP in differentiating PGL from AGC were 0.64 (0.55, 0.72),0.81 (0.74, 0.88) and 0.87 (0.81, 0.93), respectively. Combining dual-phase parameters (NICVP, λAP, λVP) with serosal invasion achieved an AUC and 95% CI of 0.98 (0.95, 1.00), with sensitivity of 92.2% and specificity of 86.2%. Conclusions DECT-derived iodine quantification parameters (NICVP, λAP, λVP) demonstrate significant differences between PGL andAGC, with higher values observed in AGC. DECT imaging facilitates preoperative differentiation between PGL and AGC. The combina. tion of DECT parameters with serosal invasion improves diagnostic sensitivity and specificity, offering enhanced clinical utility. |
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