Diagnostic value of spectral CT with multimodal parameters in evaluation of lymphatic metastasis of gastric adenocarcinoma / 实用放射学杂志

ABSTRACT

Objective To evaluate the value of energy spectrum CT with multimodal quantitative parameters in diagnosis of the metastatic lymph nodes of gastric adenocarcinoma compared with the conventional CT.Methods 37 patients with gastric adenocarcinoma diagnosed by gastroscopy underwent enhanced CT scan with gemstone spectral imaging mode.We positioned and marked the stomach lymph nodes on CT images and compared with postoperative pathologic results one to one.ROC was used to identify the critical quantitative index of energy spectrum CT in distinguishing the metastasis from benign lymph node,and to evaluate the diagnostic effect compared with CT features.Results The 40-80 keV single energy spectrum curve slope (λHU )and normalized iodine concentration (NIC)in metastasis group were lower than those in the benign one in the arterial phase with statistical differences (P <0.05 ),but without statistical differences in venous phase.The combination of arterialλHU and NIC showed significant advantages compared with CT features(P <0.01), with the sensitivity,specificity and accuracy of 84.3% vs 61.4 %,88.4% vs 81.3 % and 86.8% vs 73.6 %.Conclusion The energy spectrum CT can provide quantitative analysis for differential diagnosis of gastric cancer metastasis from benign lymph nodes,and significantly improve the diagnostic accuracy of lymph node metastasis of the cancer.