16层螺旋CT胰腺癌灌注研究

The Study of Tumor Perfusion in Pancreatic Carcinoma with 16-Slice Helical CT

目的探讨正常胰腺和胰腺癌的MSCT灌注成像特征。方法30例无胰腺疾病的患者和16例经病理证实的胰腺癌患者,采用16层螺旋CT进行灌注扫描,分别测量30例正常胰腺组织和16例胰腺癌肿瘤组织及周围正常胰腺组织的血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)值,并进行分析。结果胰腺CT灌注的各项指标个体差异较大,但正常胰腺组织和癌周相对正常的胰腺组织的BF、BV、PS和MTT的平均值差异无显著性意义。正常胰腺组织和癌周相对正常胰腺组织的BV、BF高于胰腺癌组织,PS低于胰腺癌组织。胰腺癌周围相对正常胰腺组织与胰腺癌组织PS、BV和BF前后配对t检验差异更加明显。结论CT灌注成像技术对胰腺癌诊断具有重要的提示意义。

Objective：To evaluate the technique and application value of 16 slices spiral-CT perfusion for normal and tumorous pancreas. Methods;Perfusion CT for pancreatic cancer was performed with 16-section multi-detector row CT in 16 patients （all of them were then confirmed by pathology）. 30 patients with no pancreatic disorders served as controls. Contrast medium-enhanced dynamic CT was performed,and the data were analyzed by using commercial software to calculate tissue blood flow （BF）, blood volume （BV）, mean transit time （MTT）, and vascular permeability-surface （PS） area product. Perfusion parameters of normal pancreas, tumors tissues and the pancreatic tissues near tumors were compared. Results： There were remarkable individual differences between parameters in the CT perfusion： pancreatic cancer showed higher PS and lower BV and BF compared with those of normal pancreas. But there were no significant differences in baseline BF,BV, P$ and MTT values between normal pancreas and pancreatic tissues near tumors. However,statistical results showed more significant differences between normal pancreatic tissues and pancreatic cancer tissues. Conclusion：CT perfusion imaging can be used to identify patients with pancreatic carcinomas,because individual differences exist in the results of CT perfusion, and the changes of different parts in the same patient were more significant.