多层螺旋CT肿瘤灌注成像的临床应用价值

Clinical utility of intratumoral perfusion imaging using multislice helical CT

目的重点探讨多层螺旋CT(MSCT)的肿瘤灌注成像方法和临床应用价值。方法对74例患者的全身不同各部位肿瘤行MSCT灌注成像,在常规CT平扫的基础上确定肿瘤中心部位后进行肿瘤灌注扫描,扫描图像经ADW4.2工作站处理,计算并分析灌注图像和灌注参数,包括血流量、血容量、平均通过时间、表面通透性以及肝脏肿瘤的肝动脉灌注指数。结果74例患者的灌注成像中,除3例未能捕捉肿瘤中心的灌注图像外,其余71例肿瘤的灌注图像均清晰直观地显示肿瘤的大小和轮廓,并可定量检测肿瘤内部的组织灌注状态,所有肿瘤灌注参数明显变化,肺部肿瘤灌注成像受呼吸运动影响最大。结论MSCT的肿瘤灌注成像是一种较为准确的定量分析肿瘤血流灌注状态的方法,具有重要的临床应用价值。

Objective To discuss the modality of intratumoral perfusion imaging using muttislice helical computed tomography（MSCT） and its clinical utility. Methods Seventy - four patients with tumor which occurred in different partes of whole body underwent intratumoral perfusion imaging using MSCT after conventional plain CT scanning and demonstrating the central partes of tumors. Scanning images were transferred into ADW 4.2 work station to calculate and analyze perfusion images and parameters such as blood flow（BF）, blood volume （BV）, mean transit time （MTT）, permeability surface （PS） and hepatic arterial index （HAI）. Results The perfusion images of tumor in 3 cases could not be caught while those in 71 cases could clearly and directly display tumoral diameters and outlines, and could quantitatively monitor blood flow perfusion state of intratumoral structures. The perfusion parameters of all tumors showed remarkable change. Pulmonary tumors were most easy influeced by breath movement. Conclusion lntratumoral perfusion imaging using MSCT is an accurate means for analyzing blood perfusion state in tumors and therefore it has important clinical utility.