【摘要】 目的 探讨宝石能谱CT多参数成像对肝癌病理分化程度及淋巴结转移的诊断价值。方法 选取2023年1月至2024年4月在本院确诊的76例肝癌患者，所有受试者均接受宝石能谱CT检查，记录相关参数[能谱曲线斜率、碘含量及水含量]。根据肿瘤的病理结果将76例患者分为高分化(n=28)、中分化(n=30)、低分化(n=18)三组，比较三组能谱CT参数，分析其相关性。根据患者淋巴结转移情况将其分为转移组(n=21)和非转移组(n=55)，比较两组能谱CT参数。ROC分析能谱CT参数对淋巴结转移的诊断价值。结果 不同病理分化程度下患者水含量比较，差异无统计学意义(P>0.05)。低分化组患者的能谱曲线斜率和碘含量水平均较中分化组和高分化组高，且中分化组水平较高分化组水平高，比较差异有统计学意义(P<0.05)。相关性分析结果显示，能谱曲线斜率和碘含量水平和病理分化程度的相关系数分别为r=0.352和0.388(P<0.05)，表明能谱曲线斜率和碘含量水平和病理分化程度呈正相关。转移组和非转移组患者的动脉期标准化碘浓度(NIC)和门静脉期NIC比较，差异无统计学意义(P>0.05)，转移组患者动脉期LNR和门静脉期碘浓度比(LNR)较非转移组低，差异有统计学差异(P<0.05)。ROC分析结果显示：动脉期LNR和门静脉期LNR诊断肝癌患者淋巴结转移得到ROC下曲线面积为0.827和0.685，具有较好诊断价值。结论 宝石能谱CT多参数成像在评估肝癌病理分化程度和淋巴结转移方面具有较好临床价值。更多还原

【Abstract】 Objective To explore the diagnostic value of gemstone spectral CT multi-parameter imaging in pathological differentiation degree and lymph node metastasis in liver cancer.Methods A total of 76patients with liver cancer confirmed in the hospital were enrolled between January 2023 and April2024.All underwent gemstone spectral CT examination to record relevant parameters(spectral curve slope,iodine content,water content).According to pathological results of tumors,patients were divided into high differentiation group(n=28),moderate differentiation group(n=30) and low diffe rentiation group(n=18).The spectral CT parameters in the three groups were compa red,and their correlation was analyzed.According to presence or absence of lymph node metastasis,patients were divided into metastasis group(n=21) and non-metastasis group(n=55),and spectral CT parameters in the two groups were compared.The diagnostic value of spectral CT parameters in lymph node metastasis was analyzed by ROC curves.Results There was no significant difference in water content among patients with different pathological differentiation degree(P>0.05).The spectral curve slope and iodine content were gradually increased in high differentiation group,moderate differentiation group and low differentiation group(P<0.05).The results of correlation analysis showed that spectral curve slope and iodine content were positively correlated with pathological differentiation degree(r=0.352,0.388,P<0.05).There was no significant difference in normalized iodine concentration(NIC)during arterial and portal vein phases between metastasis group and non-metastasis group(P>0.05).The lesion-normal ratio(LNR) values during arterial and portal vein phases in metastasis group were lower than those in non-metastasis group(P<0.05).The results of ROC curves analysis showed that area under ROC curve(AUC) values of LNR during arterial and portal vein phases in the diagnosis of lymph node metastasis were 0.827 and 0.685,showing good diagnostic value.Conclusion Gemstone spectral CT multi-parameter imaging has good clinical value in evaluating pathological differentiation degree and lymph node metastasis in liver cancer.更多还原