胰腺癌的多层螺旋CT灌注成像研究

Clinical Application of Multi Detector Spiral CT Perfusionin Diagnosis of Pancreatic Carcinoma

目的探讨多层螺旋CT灌注成像对胰腺癌的诊断价值。资料与方法胰腺癌患者50例,男29例,女21例,年龄均在40岁以上。均采用多层螺旋CT进行灌注扫描,其中手术后病理证实32例,另外18例仅为临床及影像学诊断。癌变发生于胰头部37例(男21例,女16例),胰体尾部13例(男8例,女5例)。分别测量肿瘤组织及周围正常胰腺组织的血流量(BF)、血容量(BV)、峰值增强影像(PEI)、到达峰值时间(timetopeak,TTP)、平均通过时间(MTT,MTT=BV/BF)值,并进行统计分析。结果胰头部癌37例和胰尾部癌中的8例男性患者中。病变区的BF、PEI、BV低于胰体部正常组织,MTT与TTP高于胰体部正常组织,其差异有统计学意义。胰尾部癌中的5例女性患者中,病变区的BF、PEI、BV低于胰体部正常组织,MTT高于胰体部正常组织,其差异有统计学意义,而TTP差异无统计学意义。结论CT灌注成像技术对胰腺癌的诊断具有重要意义。

Objective To study the diagnostic value of multi detector spiral CT in measuring the blood flow value of pancreatic carcinoma. Materials and Methods 50 patients with pancreatic cancer （32 cases were confirmed by pathology, and 18 cases were confirmed by clinical data and images） were studied by multi detector spiral CT perfusion. All the 50 patients were more than 40 years old. The lesions occurrred in the head of pancreas in 37 cases（21 male, 16 female） ,in the body and tail in 13 cases（8 male, 5 female）. The data of dynamic enhanced CT were analyzed using commercial software to calculate tissue blood flow （BF） , blood volume （BV） , peak enhancement image （PEI） , time to peak （TTP）, mean transit time （ MTT, MTT = BV/BF）. Perfusion parameters of tumor tissues and the pancreatic tissue near tumors were compared. Results Among 37 patients with carcinoma in head of pancreas and 8 male patients with carcinoma in tail of pancreas, the parameters of BF, PEI, BV in lesions were significant lower than that of in normal tissue （ P 〈 0.05 ）. Otherwise, MTT and, TTP in lesions showed higher than that of in normal pancreatic tissue （ P 〈 0.05 ）. Among 5 female patients of the carcinoma in tail of pancreas, there was difference between the lesion and the body of normal pancreatic tissue, BF, PEI, BV in lesions showed significant lower and MTT,TTP showed higher than that of in normal pancreatic tissue. Conclusion CT perfusion imaging play an important role in diagnosis for pancreatic carcinoma.