| Objective To evaluate the use of energy spectrum CT quantitative parameters compared with the use of conventional CT imaging features for diagnosis of the metastasis and benign lymph nodes in gastric adenocarcinoma.Method Totally 37 patients with gastric adenocarcinoma diagnosed by gastroscopy underwent enhanced CT scan by GSI mode. We positioned and marked the stomach lymph nodes in CT image and correlated with postoperative pathologic results one to one. By using ROC to identify energy spectrum CT quantitative index critical value in distinguishing the metastasis and benign lymph node, and evaluate the diagnostic performance compared with the traditional method of CT.Result The 40～80 kev single energy spectrum curve slope, and NIC in metastasis group lymph nodes is below than the benign in the arterial phase,and the differences were statistically significant (2.46±0.79 vs 3.63±0.70, P<0.01; 0.19±0.04 vs 0.26 ±0.07, P<0.01),while there was no statistically significant difference in venous phase (4.22±0.62 vs 4.26±0.61, P=0.916; 0.61±0.11 vs 0.61±0.08, P=0.730) The diagnostic efficacy of arterial phase HU was higher than that of arterial phase NIC (The area under the ROC curve was 0.876 vs 0.824), and the sensitivity was 78.6% and the specificity was 90%, which was the diagnosis of metastatic lymph nodes in gastric cancer.The combination of γHU and NIC has significant advantages compared with traditional CT method to diagnose gastric cancer metastasis lymph nodes for sensitivity (84.3% vs61.4%, P< 0.01), specific degrees (88.4% vs81.3%, P< 0.01) and accuracy (86.8% vs73.6%, P< 0.01), positive predictive value (81.9% vs67.2%, P< 0.01), and negative predictive value (90.0% vs77.1%, P< 0.01).Conclusion The energy spectrum CT could provide quantitative analysis for differential diagnosis gastric cancer metastasis and benign lymph nodes, and significantly improve the diagnostic accuracy of regional lymph node metastasis of gastric cancer. |
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