Dual-source CT in Differential Diagnosis of Inflammatory Bowel Disease Reactive Hyperplasia Lymph Nodes and Metastatic Lymph Nodes of Colorectal Cancer / 中国医学影像学杂志

ABSTRACT

Purpose To explore the clinical value of iodine content and energy spectrum in dual-source dual-energy CT scan in the diagnosis of inflammatory bowel disease reactive hyperplasia lymph nodes (LNs) and metastatic LNs in patients with colorectal cancer.Materials and Methods Complete dual energy scanning data of 51 reactive LNs in 30 patients with inflammatory bowel disease (15 cases of ulcerative colitis,15 cases of Crohn's disease) and 35 metastatic LNs in 20 patients with colorectal cancer confirmed by colonoscopy or pathology were collected and retrospectively analyzed.The iodine contents of reactive hyperplasia LNs and metastatic LNs were detected and the slopes of energy spectrum curves were compared between the two different pathological LNs.Moreover,the receiver operating characteristic curve was applied to determine the optimum sensitivity and specificity of differential diagnosis of these two kinds of LNs.Results The iodine contents of inflammatory bowel disease reactive hyperplasia LNs and metastatic LNs in patients with colorectal cancer in arterial phase were (2.66±0.70) mg/ml and (1.65± 0.81) mg/ml,and the slopes of curves were 2.81 ±0.56 and 0.14±0.09,respectively.There were significant differences in the iodine contents and the slopes of the energy spectral curves between these two kinds of LNs in arterial phase (P＜0.05).Moreover,the diagnostic efficacy of energy spectrum curve slope,of which the sensitivity,specificity and area under the curve was 96.7％,76.7％ and 0.846,respectively;was higher than those of iodine content in diagnosing inflammatory bowel disease reactive hyperplasia LNs and metastatic LNs.Conclusion Dual-source dual-energy CT-derived arterial phase measurement of iodine content and slope of energy spectral curve has certain significance for differential diagnosis of inflammatory bowel disease reactive hyperplasia LNs and metastatic LNs,and the slope of spectral curve is superior to iodine.