Differentiating malignant from benign gastric mucosal lesions with quantitative analysis in dual energy spectral computed tomography Initial experience
Differentiating malignant from benign gastric mucosal lesions with quantitative analysis in dual energy spectral computed tomography Initial experience
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双能谱计算机断层扫描定量分析区分恶性与良性胃粘膜病变初步经验
DOI：
10.1097/md.0000000000005878
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发表时间：
2017-01-01
期刊：
影响因子：
1.6
通讯作者：
Hu, Daoyu
中科院分区：
文献类型：
--
作者：
Meng, Xiaoyan;Ni, Cheng;Hu, Daoyu
探讨双能谱计算机断层扫描（DESCT）定量分析在鉴别胃黏膜良性病变（包括胃炎症[GI]和正常胃黏膜[NGM]）中的价值。本研究经伦理委员会批准，所有患者均提供书面知情同意书。本研究共纳入161例连续患者（63例胃癌[GC]， 48例GI， 50例NGM），他们在动脉期（AP）和门静脉期（PVP）进行了双期对比增强DESCT扫描。病灶内碘浓度（IC）由碘基物质分解图像得到，并与主动脉内碘浓度归一化得到归一化IC （nIC）。计算AP和PVP中IC和nIC的比值。通过回顾常规多色图像的胃壁厚度、病灶和偏心等特征来评估胃癌和胃肠道的诊断可信度。采用SPSS 17.0统计软件（SPSS, Chicago， IL）进行统计分析。除nIC（AP）在GC与GI之间存在差异外，GC的IC和nIC与GI和NGM之间存在显著差异。GC的平均nIC值（AP为0.18 +/- 0.06，PVP为0.62 +/- 0.16）显著高于NGM (AP为0.12 +/- 0.03，PVP为0.37 +/- 0.08)（均P < 0.05）。GC、GI和NGM的IC值也存在显著差异（AP分别为24.19 +/- 8.27、19.07 +/- 5.82和13.61 +/- 2.52mg/mL， PVP分别为28.00 +/- 7.01、24.66 +/- 6.55和16.94 +/- 3.06 mg/mL）。基于受试者工作特征曲线分析，PVP中nIC和IC对GC和NGM的鉴别灵敏度分别为88.89%和90.48%，而AP的鉴别灵敏度分别为71.43%和88.89%。IC和nIC比值由于曲线下面积小于0.65，不能提供足够的诊断准确性。结合常规特征，GC和GI的诊断准确率分别为75.0%和98.0%。定量分析胃黏膜的DESCT成像参数，如nIC和IC，有助于鉴别胃黏膜病变的良恶性。
To investigate the value of quantitative analysis in dual energy spectral computed tomography (DESCT) for differentiating malignant gastric mucosal lesions from benign gastric mucosal lesions (including gastric inflammation [GI] and normal gastric mucosa [NGM]). This study was approved by the ethics committee, and all patients provided written informed consent. A total of 161 consecutive patients (63 with gastric cancer [GC], 48 with GI, and 50 with NGM) who underwent dual-phase contrast enhanced DESCT scans in the arterial phase (AP) and portal venous phase (PVP) were included in this study. Iodine concentration (IC) in lesions was derived from the iodine-based material-decomposition images and normalized to that in the aorta to obtain normalized IC (nIC). The ratios of IC and nIC between the AP and PVP were calculated. Diagnostic confidence for GC and GI was evaluated with reviewing the features including gastric wall thickness, focal, and eccentric on the conventional polychromatic images. All statistical analyses were performed by using statistical software SPSS 17.0 (SPSS, Chicago, IL). IC and nIC in GC differed significantly from those in GI and NGM, except for nIC(AP) in comparing GC with GI. Mean nIC values of GC (0.18 +/- 0.06 in AP and 0.62 +/- 0.16 in PVP) were significantly higher than that of NGM (0.12 +/- 0.03 in AP and 0.37 +/- 0.08 in PVP) (all P < 0.05). There was also significant difference for IC values in GC, GI, and NGM (24.19 +/- 8.27, 19.07 +/- 5.82, and 13.61 +/- 2.52mg/mL, respectively, in AP and 28.00 +/- 7.01, 24.66 +/- 6.55, and 16.94 +/- 3.06 mg/mL, respectively, in PVP). Based on Receiver Operating Characteristic Curve analysis, nIC and IC in PVP had high sensitivities of 88.89% and 90.48%, respectively, in differentiating GC from NGM, while the sensitivities were 71.43% and 88.89% during AP. Ratios IC and nIC ratios did not provide adequate diagnostic accuracy with their area under curves less than 0.65. With the conventional features, the diagnostic accuracies for GC and GI were 75.0% and 98.0%, respectively. Quantitative analysis of DESCT imaging parameters for gastric mucosa, such as nIC and IC, is useful for differentiating malignant from benign gastric mucosal lesions.