肾透明细胞癌CT灌注成像及CTU成像与临床

Renal Clear Cell Carcinoma by CT Perfusion Imaging and CTU Urologic Imaging and Its Clinic

目的探讨MSCT灌注成像及CTU成像对肾透明细胞癌血流灌注的定量诊断价值及CTU特征表现。方法对经手术病理证实的肾透明细胞癌58例,回顾性分析肿瘤生长活跃部分及对侧正常肾肾皮质血流灌注数据,分别计算血流量(BF)、血容量(BV)、对比剂平均通过时间(MTT)及毛细血管表面通透系数(PS),进行对比分析、定量研究;分析CTU扫描各期横断及三维重建特征性表现及CT值。结果肿瘤灌注参数为:BF(335.04±79.74)mL/(min.100 g)、BV(26.96±5.66)mL/100 g、MTT(5.88±1.10)sec、PS(37.14±12.49)mL/(min.100 g);肾皮质为:BF(453.76±41.40)mL/(min.100 g)、BV(18.63±3.20)mL/100 g、MTT(4.47±1.15)sec、PS(53.57±9.51)mL/(min.100 g),两组间差异均有显著统计学意义(P<0.01);CTU肿瘤多不均匀低密度而富血供。结论 MSCT灌注成像能够定量评价肾透明细胞癌的血流动力学变化,结合CTU可同时反映肿瘤的形态和功能,并能判断预后,具有重要的临床应用价值。

Objective To discuss the quantitative diagnostic value of MSCT perfusion imaging and CT urologic imaging （CTU） in blood perfusion of renal clear cell carcinoma, and observe the characteristic performances of CTU. Methods 58 cases of renal clear cell carcinoma proved by operation were adopted. By analyzing retrospectively the blood perfusion data of active part of the tumor and contrahteral normal renal cortical, calculating blood flow （BF）, blood volume （BV）, mean transit time of contrast （MTr） and permeability coefficiet （PS） both in active part of tumor and contralateral normal renal cortical, comparative analysis and quantitative study are to be carried out. To analyze the period images of CTU including characteristic performance and CT value of plain scanning and three-dimensional reconstruction. Results Perfusion parameters of tumor： BF （335.04±79.74） mL/ （min · 100 g）, BV （26. 96±5. 66） mL/100 g, MTT （5. 88±1.10） sec, PS （37. 14±12. 49） mL/ （min · 100 g）. Perfusion parameters of renal cortical： BF （453.76±41.40） mL/ （min · 100 g）, BV （18.63±3.20） mL/100 g, MTT（4.47±1.15） see, PS （53.57±9.51） mL/ （ min · 100 g）. There is significant statistical difference between two groups （P〈 0. 01 ）. Most CTU tumors are uniform density and rich blood supply. Conclusions MSCT perfusion imaging can quantitatively assess hemodynamies variation of renal clear cell carcinoma, combined with CTU imaging can reflect the form and function of tumors and determine the prognosis, which has important clinical application value.