【摘要】 目的 探讨CT能谱成像在乳腺癌腋窝淋巴结转移诊断中的价值。方法 根据入组标准,本研究纳入行CT能谱双期增强扫描的乳腺癌患者27例,将图像标记的淋巴结与术后病理进行一一对照。分析乳腺癌灶、转移淋巴结、非转移淋巴结的动脉期、静脉期标准化碘基值（NIC-A,NIC-V）、能谱曲线斜率(λ_HU)有无统计学差异;采用受试者工作特征曲线（ROC曲线）分析比较4个参数(NIC-A、NIC-V、动脉期λ_HU、静脉期λ_HU)对乳腺癌腋窝淋巴结转移的诊断效能。结果 乳腺癌灶、转移淋巴结及非转移淋巴结的4个参数(NIC-A、NIC-V、动脉期λ_HU、静脉期λ_HC)组间差异有统计学意义。组内两两比较,乳腺癌灶与非转移淋巴结、转移淋巴结与非转移淋巴结的4个参数差异均有统计学意义;乳腺癌灶与转移淋巴结的NIC-V差异有统计学意义;以NIC-A 0.148作为转移淋巴结的诊断阈值,其诊断效能最高[曲线下面积（AUC）0.888,敏感度80.00%,特异度84.62%]。结论CT能谱成像有助于提高乳腺癌腋窝淋巴结转移的诊断准确性,可作为临床诊断参考依据。更多还原

【Abstract】 Objective To investigate the value of spectral CT imaging in diagnosis of axillary lymphatic metastasis of breast carcinoma.Methods 27 cases of breast carcinoma who met the criteria underwent dual-phase enhanced spectra CT scan.The axillary lymph nodes were matched one-to-one between CT images and postoperative pathology.The four parameters,including NIC-A,NIC-V,λ_HU-A,and λ_HU-V were analyzed among primary tumors,metastasis and non-metastasis lymph nodes.The area under receiver operating characteristic（ROC） curves of the four parameters were used to evaluate the diagnostic accuracy in axillary lymphatic metastasis.Results The four parameters showed significant differences among the primary tumors,metastasis lymph nodes and non-metastasis lymph nodes.The four parameters were also significantly different between the primary tumors and non-metastasis lymph nodes,between metastasis lymph nodes and non-metastasis lymph nodes.Only NIC-V was significantly different between the primary tumors and metastasis lymph nodes.When NIC-A value of 0.148 was used as the threshold for diagnosing lymphatic metastasis,the sensitivity,specificity and the area under the curve were 80.00%,84.62% and 0.888,respectively.Conclusion The parameters of spectral CT imaging can significantly improve the diagnostic accuracy of axillary lymphatic metastasis of breast carcinoma,which can be used as a reference for clinical diagnosis.更多还原