原发性肝癌患者淋巴结转移CT能谱成像表现特征研究*

doi:10.3969/j.issn.1672-5069.2026.04.030

实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (4): 597-600.doi: 10.3969/j.issn.1672-5069.2026.04.030

原发性肝癌患者淋巴结转移CT能谱成像表现特征研究^*

林建坤, 张育娟, 陈思敏, 林成灿, 季鸿翔, 刘昌华

361003 福建省厦门市陆军第七十三集团军医院医学影像科(林建坤,张育娟,陈思敏,刘昌华);普外科(季鸿翔);福建医科大学附属第一医院医学影像科(林成灿)

收稿日期:2025-11-17 出版日期:2026-07-10 发布日期:2026-07-20
通讯作者: 刘昌华,E-mail:liuxingc@126.com
作者简介:林建坤,男,36岁,大学本科,主管技师。E-mail:18759218702@163.com
基金资助:
^*福建省厦门市医疗卫生指导性科研项目(编号:3502Z20224ZD1240);厦门市自然科学基金资助项目(编号:3502Z20227125)

CT spectral imaging features of lymph node metastasis in patients with primary liver cancer

Lin Jiankun, Zhang Yujuan, Chen Simin, et al

Department of Radiology, Army Hospital, 73rd Group, Xiamen 361003, Fujian Province, China

Received:2025-11-17 Online:2026-07-10 Published:2026-07-20

摘要/Abstract

摘要： 目的探讨原发性肝癌(PLC)患者淋巴结转移的电子计算机断层扫描(CT)能谱成像特征,以为临床诊断提供线索。方法 2023年1月～2025年6月我院收治的118例PLC患者,均接受CT能谱成像检查,选择典型淋巴结,测量碘浓度(IC)、标准化碘浓度(NIC)和能谱曲线斜率(λHU)。所有患者接受根治性手术切除肿瘤和可疑淋巴结,行组织病理学检查。结果在118例PLC患者中,病理学检查检出淋巴结转移者31例(26.3%),未见淋巴结转移者87例(73.7%);转移组肿瘤直径为(5.9±1.5)cm,显著大于未转移组【(5.1±1.2)cm,P<0.05】,肿瘤临床Ⅲ/Ⅳ期占比为61.3%,显著高于未转移组的36.8%(P<0.05);转移淋巴结增强扫描动脉期IC、NIC和λHU分别为(12.9±3.1)×100 μg/cm³、(0.3±0.1)×100 μg/cm³和(1.5±0.2),均显著低于未转移淋巴结【分别为(19.3±3.8)×100 μg/cm³、(0.5±0.1)×100 μg/cm³和(1.9±0.4),均P<0.05】。结论 CT能谱成像能够通过定量参数测定及时发现PLC患者转移的腹腔淋巴结,可为临床判断肿瘤分期和制定手术方案提供帮助。

关键词: 原发性肝癌, 淋巴结转移, CT能谱成像, 特征

Abstract: Objective The aim of this study was to investigate computed tomography (CT) spectral imaging features of lymph node metastasis in patients with primary liver cancer (PLC). Methods 118 consecutive patients with PLC were encountered in our hospital between January 2023 and June 2025, and all received CT spectral imaging to record iodine concentration (IC), normalized iodine concentration (NIC) and slope of spectral curve (λHU) of interested lymph nodes. All patients underwent radical resection of intrahepatic tumors and adjacent enlarged lymph nodes. Results Of the 118 patients with PLC, histopathological examination found lymph node metastasis in 31 cases(26.3%),and without lymph node metastasis in 87 cases (73.7%); tumor diameter in lymph node metastasis group was(5.9±1.5)cm, significantly greater than [(5.1±1.2)cm, P<0.05],and percentage of tumor stage Ⅲ/Ⅳ was 61.3%,significantly higher than 36.8%(P<0.05) in those without lymph node metastasis group; IC, NIC and λHU at arterial phase in lymph node metastasis group were (12.9±3.1)×100 μg/cm³,(0.3±0.1)×100 μg/cm³ and (1.5±0.2),all significantly lower than [(19.3±3.8)×100 μg/cm³, (0.5±0.1)×100 μg/cm³ and (1.9±0.4),respectively, all P<0.05] in those without metastasis. Conclusion CT spectral imaging could effectively identify lymph node metastasis in time in patients with PLC, which might help determine clinical tumor stages and put forward management strategy.

Key words: Hepatoma, Lymph node metastasis, CT spectral imaging, Feature

林建坤, 张育娟, 陈思敏, 林成灿, 季鸿翔, 刘昌华. 原发性肝癌患者淋巴结转移CT能谱成像表现特征研究^*[J]. 实用肝脏病杂志, 2026, 29(4): 597-600.

Lin Jiankun, Zhang Yujuan, Chen Simin, et al. CT spectral imaging features of lymph node metastasis in patients with primary liver cancer[J]. Journal of Practical Hepatology, 2026, 29(4): 597-600.

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原发性肝癌患者淋巴结转移CT能谱成像表现特征研究^*

CT spectral imaging features of lymph node metastasis in patients with primary liver cancer

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