肺癌介入治疗前后MSCT灌注成像参数变化的临床意义

Clinical significance of parameter changes of MSCT perfusion imaging in patients with lung cancer before and after interventional therapy

目的:探讨中晚期肺癌介入治疗前后MSCT灌注成像灌注参数变化的临床意义。方法:选择29例中晚期肺癌患者,介入治疗前及治疗后4周行MSCT灌注成像,采用电影技术对瘤体中心层面进行动态灌注扫描,计算瘤体的血流量(BF)、血容量(BV)、平均通过时间(MTT)、毛细血管表面通透性(PS),测量并比较介入治疗前后各项灌注参数的变化,并在介入治疗3个月后行常规CT检查观察肿瘤形态变化。结果:24例肺癌介入治疗后,肿瘤BF、BV降低,MTT显著升高,PS变化不明显(差异有统计学意义,P<0.05),3个月后随访观察瘤体组织出现不同程度缩小;5例肺癌BF、BV、MTT、PS均无明显变化(P>0.05),3个月后随访观察瘤体显示不同程度增大或无明显变化。结论:肺癌介入治疗前后MSCT灌注成像灌注参数变化在肿瘤疗效预测方面有很大的临床意义。

Objective：To investigate the parameter changes of MSCT perfusion imaging in patients with advanced lung cancer before and after interventional therapy so as to evaluate the therapeutic efficacy.Methods：MSCT perfusion scans were performed in thirty patients with advanced lung cancer before and after 4 weeks of the interventional therapy.Contrast medium-enhanced dynamic CT was performed with a static table position in the center of the cancer,and the data were analyzed by using commercial software to calculate tissue blood flow（BF）,blood volume（BV）,mean transit time（MTT）,and vascular permeability surface area product（PS）.Perfusion parameters before and after interventional therapy were compared.Then unenhanced CT scans were performed after 3 months to assess the changes in tumors size.Results：After interventional therapy,24 patients showed significant reduction in BF and BV,but increase in MTT,no change in PS.Perfusion parameters had statistical significance before and after interventional therapy（P0.05）,the tumors became smaller after 3 months;5 patiens showed no significant changes in all parameters（P0.05）,the tumors had been shown no significant change in size after 3-month follow up.Conclusion：The parameter changes of MSCT perfusion imaging can evaluate the therapeutic efficacy for patients with advanced lung cancer before and after interventional therapy.