多层螺旋CT对胰腺癌的灌注成像研究

Multiple-slice spiral CT perfusion imaging of pancreatic cancer

目的 应用MSCT灌注成像技术测量和评价正常胰腺和胰腺癌的血流动力学表现,探讨其在胰腺癌诊断中的临床应用价值.方法 对44例无胰腺疾病患者(正常胰腺患者)、18例胰腺癌患者行MSCT胰腺灌注检查,采用Siemens Bodyperfusion软件测量正常胰腺患者及胰腺癌患者的CT灌注参数值,包括血流量(BF)、血容量(BV)、灌注起始时间(TTS)、峰值到达时间(TTP)、渗透性(permeability)、patlak血流容积(pBV)的平均值,并进行统计学分析.结果 正常胰腺组的BF、BV、TTS、TTP、permeability和pBV分别为:(90.60±29.25)ml·100 ml-1·min-1、(190.35±43.8)ml/L、(205.3±16022)s、(1403.5±334.0)s、(99.47±49.9)05 ml·100ml-1·min-1和(157.8±52.5)ml/L,胰腺癌组的BF、BV、TTS、TTP、permeability和pBV分别为:(22.9±10.63)ml·100 ml-1·min-1、(52.38±18.08)ml/L、(194.3±76.0)s、(1549.5±308.5)s、(115.25±33.55)0.5·100 ml-1·min-1和(83.16±41.45)ml/L.胰腺癌组BF、Bv、pBV明显低于正常组,渗透性高于正常胰腺组,其差异有统计学意义(P<0.01);而两组的TTS和TTP值比较差异无统计学意义(P>0.05).结论 正常胰腺和胰腺癌的CT灌注参数值存在差异,MSCT灌注成像对胰腺癌的诊断有一定的临床价值.

Objective To assess the diagnostic value of multiple-slice spiral CT (MSCT) perfusion imaging technique in pancreatic cancer by measuring and comparing the dynamical characteristics of blood flow between normal pancreas and pancreatic cancer. Methods The CT perfusion imaging were obtained using Siemens Somatoma MSCT scanner in 44 patients with normal pancreas tissue and 18 patients with pancreatic cancer. The mean blood flow (BF),blood volume (BV), time to start (Trs), time to peak (TIP), permeability and patlak blood volume (pBV) were measured and statistically analyzed by using Siemens Body peHusion software package. Results The mean BF, BV, Trs, TIP, permeability and pBV of normal pancreas were: (90.60±29.25) ml·100 ml-1·min-1, (190.35±43.8) ml/L, (205.3±160.2) s, (1403.5±334.0)s, (99.47±49.9) 0.5 ml·100 ml-1·min-1, (157.8±52.5) ml/L, respectively. The mean BF, BV, TTS, TrP, per-meability and pBV of pancreatic cancer were (22.9±10. 63) ml·100 ml-1·min-1, (52.38±18.08) ml/L, (194.3±76.0) s, (1549.5± 308.5)s, (115.25±33.55) 0.5 ml·100 ml-1·min-1, (83.16±41.45) ml/L respectively. The mean BF, BV, pBV and permeability between normal pancreas and pancreatic carcinoma were statistically significant (P<0.01). However the mean TTS and TIP between normal pancreas and pancreatic carcinoma were not statistically significant (P>0.05). Conclusion There are significant differences between perfusion values of pancreatic carcinoma and normal pancreatic tissue, and MSCT perfusion imaging is helpful in diagnosing pancreatic carcinoma.