64层螺旋CT对胰腺癌的灌注成像研究

64-slice spiral CT perfusioni maging of pancreatic cancer

目的应用64层螺旋CT灌注扫描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,并探讨其在胰腺癌诊断中的作用。方法正常胰腺40例,胰腺癌患者15例,行64层螺旋CT胰腺灌注检查,采用Siemens Body perfu-sion软件测量所有病例的正常胰腺实质和胰腺癌部位的CT灌注参数:血流量(BF)、血流容积(BV)、灌注起始时间(TTS)、达峰时间(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:(90.7±29.26)ml.100 ml-1.min-1、(192.31±43.81)ml/L、(20.63±16.02)0.1 s、(142.38±33.4)0.1 s、(99.33±49.95)0.5 ml.100 ml-1.min-1和(157.72±52.48)ml/L;胰腺癌组的BF、BV、TTS、TTP、permeability和pBV分别为:(22.91±10.64)ml.100 ml-1.min-1、(52.28±18.06)ml/L、(19.43±7.58)0.1 s、(154.92±30.83)0.1 s、(115.23±33.55)0.5 ml.100 ml-1.min-1和(83.06±41.68)ml/L。胰腺癌组的BF、BV、pBV明显低于正常组,表明胰腺癌时的血流灌注量明显少于正常胰腺的血流灌注量;胰腺癌组的渗透性高于正常胰腺组;两组间的BF、BV、pBV及Permeability均有显著的统计学意义(P<0.01);两组间的灌注起始时间和达峰时间比较无统计学意义(P>0.05)。结论正常胰腺组和胰腺癌组的CT灌注参数比较有显著性差异。64层螺旋CT灌注成像对胰腺癌的诊断有一定的临床价值。

Objective To assess the characteristics of blood flow for normal pancreas and pancreatic cancer, and to discuss the value of 64-slice spiral CT perfusion technology. Methods The CT peftusion imaging were obtained using Siemens Somatom 64-slice spiral CT scanner in 40 patients with normal pancreas tissue and 15 patients with pancreatic cancer. The mean blood flow （BF）, blood volume （BV）, time to start （TTS）, time to peak （TTP）, permeability and patlak blood volume （pBV） were measured and statistically analyzed,using Siemens Body pefl＇usion software package. Results The mean BF, BV, TTS, TTP, permeability and pBV of normal pancreas were： （90.7±29. 26） ml · 100 ml^-1 · min^-1 ,（192.31±43.81）ml/L,（20.63±16.02）0.1 s,（142.38± 33.4）0. 1 s,（99. 33±49.95）0. 5 ml·100 ml^-1· min,（157. 72±52.48） ml/L, respectively. The mean BF, BV, TTS, TTP, permeability and pBV of pancreatic cancer were （22.91±10. 64） ml·100 ml^-1·min^-1 ,（52.28±18.06） ml/L,（19.43±7.58）0.1 s, （154.92±30. 83）0.1 s,（115. 23±33.55）0. 5 ml·100 ml^-1 · min^-1 ,（83.06±41.68） 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 TTP between normal pancreas and pancreatic carcinoma were not statistically significant （P〈0.05）. Conclusion BF, BV and pBV of pancreatic carcinoma shorten significantly. It is significant that 64-slice spiral CT pert＇usion imaging analyze the change of the blood flow for pancreatic carcinoma.