胰腺癌、慢性胰腺炎CT灌注成像在临床中的应用

Clinical application of computed tomography perfusion imaging in pancreatic carcinoma and chronic pancreatitis

目的探讨正常胰腺、胰腺癌、慢性胰腺炎的多层螺旋CT(MSCT)灌注成像特征。方法采用16层螺旋CT进行灌注扫描,分别测量32例正常胰腺组织、12例慢性胰腺炎组织和16例胰腺癌肿瘤组织及周围正常胰腺组织的血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)值,并进行统计学分析。结果正常胰腺组织和癌周相对正常的胰腺组织的BF、BV、PS和MTT的平均值差异无统计学意义(P>0.05)。正常胰腺组织和癌周相对正常胰腺组织的BV、BF高于胰腺癌组织,PS低于胰腺癌组织,差异有统计学意义(P<0.05)。慢性胰腺炎患者BV、PS与正常胰腺组织比较差异无统计学意义(P>0.05),而BF低于正常胰腺,MTT明显延长,差异有统计学意义。结论CT灌注成像技术对胰腺癌与慢性胰腺炎鉴别诊断具有重要的提示意义。

Objective To evaluate the image characteristics of multi-slices spiral computed tomography （CT） perfusion for normal and tumorous pancreas and chronic pancreatitis. Methods CT perfusion for pancreatic cancer in 16 patients and chronic pancreatitis in 12 patients were performed with 16 slices spiral CT. Thirty-two patients with no pancreatic disorders served as controls. The acquired metered data were statistically analyzed by using workstation to calculate tissue blood flow （BF） ,blood volume （BV）, mean transit time （MrIT）, and vascular permeability surface （PS） values. Perfusion parameters of normal pancreas, chronic pancreatitis, tumors tissues and the pancreatic tissues near tumors were compared. Results There were remarkable difference between parameters in the CT perfusion：pancreatic cancer showed higher PS and lower BV and BF compared with those of normal pancreas and pancreatic tissues near tumors（P 〈 0.05 ）. But there was no significant difference in baseline BF, BV, PS and MTT values between the pancreas and pancreatic tissues near tumors （ P 〉 0. 05 ）. Statistical results showed no significant difference between normal pancreatic tissues and chronic pancreatitis tissues in BV, PS （P 〉 0.05 ） . Chronic pancreatitis showed higher MTF and lower BF compared with those of normal pancreas （P 〈 0. 05 ）. Conclusion It suggests that CT perfusion imaging can be used to identify chronic pancreatitis patients with pancreatic carcinomas .