Dual energy computed tomography for detection of metastatic lymph nodes in patients with hepatocellular carcinoma

作     者：Yu-Rong Zeng Qi-Hua Yang Qing-Yu Liu Jun Min Hai-Gang Li Zhi-Feng Liu Ji-Xin Li 

作者机构：Department of Radiology Sun Yat-sen Memorial Hospital Sun Yat-sen University Department of Hepatobiliary Surgery Sun Yat-sen Memorial Hospital Sun Yat-sen University Department of Pathology Sun Yat-sen Memorial Hospital Sun Yat-sen University Department of Radiology Zengcheng District People’s Hospital of Guangzhou 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2019年第25卷第16期

页      面：1986-1996页

核心收录：

学科分类：10[医学] 

主　　题：Computed tomography Hepatocellular carcinoma Lymph node Metastasis Hepatitis Dual energy 

摘      要：BACKGROUND Regional lymph node metastasis in patients with hepatocellular carcinoma(HCC)is not uncommon, and is often under-or misdiagnosed. Regional lymph node metastasis is associated with a negative prognosis in patients with HCC, and surgical resection of lymph node metastasis is considered feasible and efficacious in improving the survival and prognosis. It is critical to characterize lymph node preoperatively. There is currently no consensus regarding the optimal method for the assessment of regional lymph nodes in patients with *** To evaluate the diagnostic value of single source dual energy computed tomography(CT) in regional lymph node assessment for HCC *** Forty-three patients with pathologically confirmed HCC who underwent partial hepatectomy with lymphadenectomy were retrospectively enrolled. All patients underwent dual-energy CT preoperatively. Regional lymph nodes(n = 156) were divided into either a metastatic(group P, n = 52) or a non-metastasis group(group N, n = 104), and further, according to pathology, divided into an active hepatitis(group P1, n = 34; group N1, n = 73) and a non-active hepatitis group(group P2, n = 18; group N2, n = 31). The maximal short axis diameter(MSAD),iodine concentration(IC), normalized IC(NIC), and the slope of the spectralcurve(λ_(HU)) of each group in the arterial phase(AP), portal phase(PP), and delayed phase(DP) were *** Analysis of the MSAD, IC, NIC, and λ_(HU) showed statistical differences between groups P and N(P 0.05) during all three phases. To distinguish benign from metastatic lymph nodes, the diagnostic efficacy of IC, NIC, and λ_(HU) in the PP was the best among the three phases(AP, PP, and DP), with a sensitivity up to 81.9%,83.9%, and 81.8%, and a specificity up to 82.4%, 84.1% and 84.1%, *** diagnostic value of combined analyses of MSAD with IC, NIC, or λ_(HU) in the PP was superior to the dual energy CT parameters alone, with a sensitivity up to84.5%, 86.9%