早期和中晚期肾透明细胞癌CT灌注成像的差异

CT Perfusion Imaging of Renal Clear Cell Carcinoma at Early Stage and Advanced Stage

目的:探讨不同分期肾透明细胞癌CT灌注成像的差异。材料和方法:经手术病理证实为肾透明细胞癌的患者40例,术前应用GE Lightspeedl6层螺旋CT,选择肿瘤最大层面进行灌注扫描。用去卷积法灌注软件获取肿瘤内多个不同密度感兴趣区及双侧肾皮质的血流量、血容量、平均通过时间、表面通透性及时间-密度曲线。40例肿瘤分为早期和中晚期两组,统计分析比较不同分期肿瘤间的灌注差异。结果:肾透明细胞癌早期肿瘤最高密度点表面通透性较中晚期肿瘤高(P=0.027),早期肿瘤最高密度点平均通过时间较中晚期肿瘤短(P= 0.039),中晚期肿瘤对双侧肾皮质血流影响较早期肿瘤明显。结论:CT灌注成像能从血流动力学和血管功能上为肾透明细胞癌更准确的分期带来帮助,具有一定的临床应用价值。

Purpose： To study The difference of CT perfusion imaging of renal clear cell carcinoma at difference stage. Materials and Methods： CT perfusion scans by GE lightspeed 16 were performed through the central slices of the tumor in 40 pathologically confirmed renal clear cell carcinoma. The software of deconvolution calculated a series of perfusion parameters of regions of interest（ROIs） in tumor and cortexes of both kidney, including blood flow（BF）, blood volume（BV）, mean transit time （MTT）, permeability surface（PS） and the time-density curve（TDC curve） . The 40 cases of clear cell carcinoma were differentiated by stage and the perfusion parameters was analyzed statistically. Results： PS of MAX - ROI（the area in tumor with maximal perfusion） in early stage tumor is higher than that in medium-late stage tumor（P = 0.027） . MTT of MAX-ROI in early stage tumor is shorter than that in medium-late stage tumor（P = 0.039） . The effect on perfusion of both renal cortex is more obviously in medium-late stage tumor than that in early stage tumor. Conclusion： CT perfusion imaging is valuable for stage of renal clear cell carcinoma.