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目的应用能谱CT增强扫描分析进展期胃癌碘含量与脉管癌栓的关系。方法对40例经病理证实的进展期胃癌患者于术前2周内行能谱CT三期增强扫描,应用物质分离技术观察碘基图上增强扫描各期肿瘤黏膜侧高强化区及整体碘含量(ICs)、相同层面腹主动脉碘含量(ICao),计算标准化碘含量(NICs)、静脉期碘含量升高率(ICERvp),分析其与脉管癌栓的相关性。结果脉管癌栓阳性者胃癌动脉期黏膜侧高强化区、整体碘含量明显高于阴性者[(3.27±0.91)mg/ml vs(2.32±0.79)mg/ml,P=0.004;(1.98±0.65)mg/ml vs(1.41±0.75)mg/ml,P=0.023];标准化后脉管癌栓阳性者碘含量仍明显高于阴性者[(0.30±0.08)mg/ml vs(0.23±0.07)mg/ml,P=0.013;(0.18±0.06)mg/ml vs(0.14±0.07)mg/ml,P=0.037];阴性者黏膜侧高强化区及整体ICERvp明显高于脉管癌栓阳性者(0.39±0.26vs 0.12±0.26,P=0.005;0.55±0.46vs 0.22±0.28,P=0.047)。结论不同增强时相中胃癌碘含量与脉管癌栓存在一定相关性。
Objective To investigate the relationship between iodine content and vascular tumor thrombosis in advanced gastric cancer by spectrally enhanced CT scan. Methods Fourty patients with pathologically proven advanced gastric cancer were scanned with two-stage contrast-enhanced spectroscopy in two weeks before operation. Substance isolation technique was used to observe the enhancement of iodine content in the mucosal side of the enhanced phase of iodine-based imaging. ICs), the same level of abdominal aorta iodine content (ICao), calculation of standardized iodine content (NICs), intravenous iodine content increase rate (ICERvp), analysis of its correlation with vascular cancer emboli. Results The iodine content in the arterial phase mucosal hyperintensity region and the total iodine content were significantly higher in patients with vascular cancer embolus than those in the negative [(3.27±0.91) mg/ml vs(2.32±0.79) mg/ml, P=0.004; (1.98± 0.65) mg/ml vs. (1.41±0.75) mg/ml, P=0.023]; the iodine content of the patients with positive tumor venous thrombosis was still significantly higher than that of the negative patients [(0.30±0.08) mg/ml vs (0.23±0.07) ) mg/ml, P=0.013; (0.18±0.06) mg/ml vs (0.14±0.07) mg/ml, P=0.037]; The negative ICERvpp in the mucosal hyperintense region and the whole body were significantly higher than those in the vasculoma. (0.39±0.26 vs 0.12±0.26, P=0.005; 0.55±0.46 vs 0.22±0.28, P=0.047). Conclusion There is a certain correlation between iodine content in gastric cancer and vascular tumor thrombus in different enhanced phases.