肺癌的CT灌注成像与脱氧葡萄糖正电子发射计算机体层扫描及肿瘤微血管密度的相关性

CT perfusion of pulmonary carcinoma:the correlative study with fluoro-deoxyglucose positron emission tomography and tumor microvessel density

目的探讨肺癌的 CT 灌注参数与微血管密度(MVD)和由脱氧葡萄糖正电子发射计算机体层扫描(FDG-PET)所得的标准摄取值(sUV)的相关性,评价 CT 灌注成像在反映肺癌肿瘤血管生成方面的价值。方法对50例肺癌患者行 CT 灌注成像,计算病灶的血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面渗透性(PS)。其中14例行 FDG-PET 检查,测量病灶的 SUV。取50例患者的病理标本作免疫组织化学 CD34染色,计数 MVD,将 CT 灌注参数与 MVD 及 SUV 进行相关性分析。结果 BF、BV、MTF 及 PS 的平均值分别为97.30 ml·100 g^(-1)·min^(-1),8.86 ml·100 g^(-1),6.75 s 及34.52 ml.100 g^(-1)·min^(-1);MVD 平均值61.82个/高倍镜;14例患者的 SUV 平均值5.96。BF与 SUV 及 MVD 均呈正相关(r 值分别为0.727、0.543,P<0.05);MVD 与 BV 及 PS 亦呈正相关(r 值分别为0.375、0.346,P<0.05);MVD 与 SUV 呈正相关(r=0.565,P<0.05)。结论 CT灌注参数与 MVD 及 SUV 相关,是在体评价肿瘤血管生成的理想方法。

Objective To investigate the correlation between CT perfusion parameters of pulmonary carcinoma and standardized uptake values （SUV） derived from ISF-fluoro-deoxyglucose positron emission tomography （SF-FDG PET） and tumor microvessel density （ MVD）, and to determine the validity of CT perfusion in assessing tumor angiogenic activity of pulmonary carcinoma. Methods Fifty patients （ mean age 57.5, 17 females） with pulmonary carcinoma underwent CT perfusion using 16-slice helical CT. Blood flow （ BF, ml · 100 g^-1 · min^-1 ） , blood volume （ BV, ml · 100 g^-1 ） , mean transmit time （ MTT, s） and permeability surface area product （PS, ml · 100 g^-1 · min^-1 ） were analyzed. SUV of PET was calculated in 14 patients. The CD34 immunohistochemical staining was used for tumor microvessel counting. CT perfusion parameters of pulmonary carcinoma were correlatively studied with SUV and tumor MVD. Pearson＇s correlation analysis was performed to evaluate the association between CT perfusion parameters and SUV and MVD. Results The average values of BF, BV, MTY and PS were 97. 30 ml · 100 g^-1 · min^-1, 8.86 ml · 100 g^-1, 6. 75 s and 34. 52 ml · 100 g^-1 · min^-1 , respectively. The average value of MVD was 61.82/FOV. The mean value of SUV was 5.96. There was positive correlation between BF and SUV （ r = 0. 727, P 〈 0. 05 ） as well as MVD （ r = 0. 543, P 〈 0. 05 ）. Both BV and PS showed no statistically significant correlation with SUV, but they all showed positive correlation with MVD （r = 0. 375 and 0. 346 respectively, P 〈 0. 05）. A trend of negative correlation was demonstrated between MTY and SUV （r=-0. 033）as well as tumor MVD （r = -0. 043 ）, though the correlation was of no statistical significance. Positive correlation was demonstrated between tumor MVD and SUV （ r = 0. 565, P 〈 0. 05 ）. Conclusions CT perfusion parameters showed good correlation with SUV obtained from PET and tumor MVD. CT Perfusion is a valuable method to assess tumor neovascularity of pulmonary carcinoma.