| Objective: Through 256-segment Revolution CT spectral scanning and multi-parameter quantitative analysis,the application value of spectral CT imaging in the evaluation of T stage and differentiation of gastric adenocarcinoma(GAC)patients before surgery was initially explored,and treatment plans were developed for clinicians and patients’ prognosis was improved.It provides effective imaging information.Methods:1.General information and scanning method: The 256-segment Revolution Spectrum CT newly introduced in our hospital was used for the examination,and 60 patients with gastric adenocarcinoma were performed with plain CT and arteriovenous phase enhanced scanning.Injected via high-pressure syringe in the elbow vein,the injection flow rate was 3.5ml / s,the dose was 1.o ml / kg.Do not take heavy metal drugs three days before the test,enter a liquid diet one day before the test,fast 8h before the test,drink 800-1000 ml of water 3 minutes before the test,and inject 6542(anisodamine)10mg intramuscularly before the scan.The mixed energy image and single energy image are obtained by energy spectrum CT scan.The standard single energy reconstruction algorithm is used to reconstruct the original data of the plain scan,arterial phase and venous phase into an image with a layer thickness of 0.625 mm and a layer spacing of 0.625 mm.Transfer to GE AW4.7 workstation.Use the energy spectrum image analysis software(GSI Viewer software)post-processing function to obtain the energy spectrum curve,single energy diagram,iodine diagram,water-based diagram,effective atomic number,and then measure the corresponding parameter values.2.Through 256-row Revolution CT,CT and plain scans of gastric adenocarcinoma patients can be obtained at the same time,two sets of graphics can be obtained at the same time,one is a mixed energy image,the other is an energy spectrum CT image,at the same time for 60 cases of gastric gland Preoperative T staging of cancer patients with mixed energy and spectroscopic images before surgery,with postoperative pathology as the gold standard,and comparing spectroscopic images with regard to whether the preoperative T staging of gastric adenocarcinoma is called traditional mixed energy imaging staging is more advantageous.In addition,60 patients with gastric adenocarcinoma were divided into low differentiation group,medium differentiation group and high differentiation group according to postoperative pathology.At the same time,the iodine concentrations of plain adenocarcinoma and arteriovenous biphasic lesions of different degrees of differentiation were measured(Iodine Concentration,IC),normalized iodine concentration(NIC),water concentration,Effective Atomic Number(Effective-Z),CT value at different single energy levels of 40-140 kev,and differences in energy spectrum parameters between gastric adenocarcinomas with different degrees of differentiation.3.Statistical method: The tool used in the statistical analysis of the data is the SPSS23.0 software package.The measurement data is represented by means ± standard deviation(x ± s),and a t test is performed on it.For counting data(including accurate diagnosis)Rate,etc.),which is reflected by the percentage method,and a chi-square test is performed on it.If P <0.05,a significant difference can be determined.Results: 1.Comparison of mixed energy imaging and spectral CT imaging with the results of postoperative pathological T staging: the accuracy rates of T1 are 93.33% and 95.00%,the accuracy rates of T2 are 90.00% and 91.67%,and the accuracy rates of T3 80.00% and 93.33% respectively,the accuracy rate of T4 a period is 85.00% and 96.67%,the accuracy rate of T4 b period is 91.67% and 96.67%,and the total accuracy rate of T is 70.00% and 86.67%,which basically can Spectral CT imaging has improved the accuracy of T staging of gastric adenocarcinoma compared to mixed energy imaging to different degrees.Among them,the difference in the total accuracy of T3,T4 a and T is statistically significant,and there is no significant difference in other stages.significance.2.(1)The CT value of the low-differentiated group at the single energy level of 40 to 90 kev in the venous phase is higher than that of the medium-highly differentiated group,and the difference is statistically significant.In the differentiated group,the difference was obvious and there was statistical significance.The normalized iodine value of the poorly differentiated group in the venous phase was higher than that in the moderately and highly differentiated group.The difference was also obvious and there was statistical significance.(3)Only 60 Kev single energy level CT value in the poorly differentiated group was higher than in the arterial phase.The difference was statistically significant in the moderately and highly differentiated group;Conclusions:1.Energy spectrum CT imaging and mixed energy imaging have higher diagnostic accuracy in the diagnosis of T stage of gastric adenocarcinoma patients,while energy spectrum CT imaging has higher image quality and various parameters in T stage of surgery before surgery Compared with mixed energy imaging,the diagnostic accuracy has been improved to different degrees,especially the diagnostic accuracy of T3,T4 a and T total have more significant differences,which can provide a more scientific and reasonable basis for clinical treatment.2.Different types of differentiated gastric adenocarcinoma energy spectrum parameter values are different.The lower the degree of differentiation,the higher the energy spectrum parameter value.The single-energy CT value,standardized iodine concentration,and energy spectrum of gastric adenocarcinoma in the low-differentiated and moderately-differentiated groups at 40-90 kev The difference in the slope of the curve is significant,which helps to evaluate the degree of gastric cancer differentiation before surgery. |
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