进展期胃癌与胃淋巴瘤CT灌注对比研究

Comparison of CT perfusion between advanced gastric cancer and gastric lymphoma

目的探讨进展期胃癌与胃淋巴瘤的CT灌注表现差异，提高胃部肿瘤，特别是胃淋巴瘤的诊断水平。方法21例经病理证实的进展期胃癌患者和14例胃淋巴瘤患者，行CT灌注扫描，采用Philips CT—Perfusion功能软件包进行分析处理，得到时间一密度曲线（TDC）、血容量（BV）、达峰时间（TTP），对比分析两组之间的差异。结果21例进展期胃癌中，15例（71．4％）的TDC曲线特征为较陡峭的上升支，持续一段时间的高灌注状态后缓慢下降；其余6例（28．6％）的TDC曲线上升支较平缓，在较高灌注水平亦持续一段时间后缓慢下降。14例胃淋巴瘤中，9例（64．3％）TDC曲线的上升支平缓，持续一段时间的高灌注状态后缓慢下降；5例（35．7％）的TDC曲线上升支平缓，在较高灌注水平持续一段时间后，下降速度较快。胃癌组BV值为（15．68±6．27）ml／100g，胃淋巴瘤组BV值为（6．37±2．37）nd／100g，胃癌的BV值明屁高于胃淋巴瘤的BV值，差异有统计学意义（P〈0．05）。胃癌与胃淋巴瘤的TTP值分别为（33．10±7．83）S和（38．77±12．41）S，差异无统计学意义（P〉0．05）。结论胃癌与胃淋巴瘤CT灌注TDC曲线和灌注参数有一定的差异，可用于两者的鉴别诊断。

Objective To investigate the difference of CT perfusion between advanced gastric cancer and gastric lymphoma, and to improve the diagnosis of gastric tumors, especially gastric Iymphoma. Methods CT perfusion was performed in 21 patients with advanced gastric cancer and 14 patients with gastric lymphoma proved by pathology. Then time density curve （ TDC）, value of blood volume （BV） and time to peak（TFP） were recorded by Philips CT-Perfusion software, and the difference between the two diseases was analyzed. Results The TDC curve of 15 in 21 cases with advanced gastric cancer had sharp inclined branch, high perfusion condition for some time and slow declined branch; and the TDC curve of the other 6 cases had mild inclined branch, high peffusion condition for some time and slow declined branch. The TDC curve of 9 in 14 cases with gastric lymphoma had mild inclined branch, high perfusion condition for some time and slow declined branch; and the TDC curve of the other 5 cases had mild inclined branch, high perfusion condition for some time and fast declined branch. The value of BV in advanced gastric cancer was higher than that in gastric lymphoma [ （15.68 ±6.27） ml/100g vs （ 6.37 ±2.37） ml/100g, P 〈 0.05 ]. But for the value of TTP, there was no difference between advanced gastric cancer and gastric lymphoma [ （33. 10 ±7.83） s vs （38.77 ±12.41 ）s , P 〉 0.05 ]. Conclusion There are some differences in TDC curve and perfusion parameters between advanced gastric cancer and gastric lymphoma, which can be helpful in differential diagnosis of these two diseases.