肾透明细胞癌CT灌注成像特点的研究

Preliminary Study of the CT Perfusion Imaging Features in Clear Cell Carcinoma of Kidney

目的:探讨肾透明细胞癌灌注成像的特点及临床应用价值。方法:37例经过手术病理证实的肾透明细胞癌患者(肿瘤生长部位均靠近肾门附近),术前均选择近肾门层面进行动态增强扫描,经过灌注软件处理分析分别获得肾癌组织及双侧肾皮质的血流量(BF)、血容量(BV)、平均通过时间(MTT)、组织通透性(PS)及时间密度曲线(TDC图)。结果:肾透明细胞癌肿瘤最高密度点血供丰富,但血流量较对侧正常皮质仍较低;肿瘤平均灌注较两侧皮质均低;肿瘤同侧肾脏皮质灌注较对侧低;肿瘤内不同密度点灌注特性不同;不同分级的肿瘤对静脉血流有不同的影响。结论:肾透明细胞癌CT灌注成像具有一定的特点,对其诊断及肾血流的评估具有一定的价值。

Objective ： To evaluate the features of CT perfusion imaging in clear cell carcinoma of kidney as well as its value in clinical application. Methods： 37 patients with pathologically proved clear cell carcinoma of kidney were recruited, all of which had the location adjacent to renal hilum. Before surgery, CT dynamic enhanced scans of the hilar area were performed and parameters including blood flow （BF）,blood value （BV）,mean transit time （MTT）,permeability surface （PS） and time-density curve （TDC） were analyzed using GE perfusion software. Results： Abundant blood supply within the ROI of highest density of the tumor was desmonstrated, yet BF was still relatively lower than that of the normal cortex of the contra-lateral kidney. The mean perfusion level of tumor was lower than that of the cortex of both kidneys,the perfusion of renal cortex of tumor side is lower than that of the contra-lateral as well. A statistical difference of perfusion features between tumor tissue with different density was observed,it also indicated a different impact on the venous perfusion among tumors of different grade. Conclusion：There is a distinctive characteristics of CT perfusion imaging in clear cell carcinoma of kidney,which helps to evaluate renal blood flow and make CT perfusion imaging a promising technique in the diagnosis of this neoplasm.