胰周脏器恶性肿瘤时胰腺的多层CT灌注成像研究

Study on Multi-slice Spiral CT Perfusion Imaging in Normal Pancreas Coexistent with Malignant Tumor of Peripancreatic Organs

目的:通过对正常胰腺与合并胰周脏器恶性肿瘤时胰腺的多层螺旋CT灌注成像对比分析,评价合并胰周脏器恶性肿瘤时胰腺的血流灌注特点。方法:胰周脏器恶性肿瘤未累及胰腺者44例列为研究组(B组),无明显上腹部病变者26例列为对照组(A组)。选择胰腺的正中层面行CT灌注,采用Toshiba Aquilion 16层螺旋CT,120kV,200mA,1.0s/r,采集层厚2mm×4,间隔1s,于肘前静脉团注对比剂50ml,6ml/s,延迟6s,数据采集45s。扫描后的影像数据传输到Vitrea 2.0后处理工作站,采用进行A、B两组胰腺灌注参数三点测量,其平均值视为最后灌注参数值,并行t检查。结果:A、B两组血流量(BF)、血容量(BV)、表面通透性(PS)和平均通过时间(MTT)的测量值分别为:(168.53±103.15)ml.100g-1.min-1,(54.00±22.15)ml.100g-1,(196.38±133.18)ml.100g-1.min-1,(365.31±130.98)0.1s和(130.03±66.58)ml.100g-1.min-1,(48.15±24.52)ml.100g-1,(259.89±206.66)ml.100g-1.min-1,(389.26±207.63)0.1s。两组参数无统计学意义(P>0.05),说明正常组与合并胰周脏器恶性肿瘤组胰腺的血供差异不明显。结论:胰周脏器发生恶性肿瘤并不影响胰腺实质的血流灌注。

Purpose： To assess the characteristics of blood flow for normal pancreas coexistent with malignant tumor of peripancreatic organs by analyzing the multi - slice spiral CT perfusion imaging features of them. Methods： Seventy patients received enhancement CT examination for the venter superior or the whole abdomen. They were divided into two groups according to the inclusive criteria： Group A and Group B. Group A, which served as the control group, consisted of 26 patients with normal pancreas, and Group B consisted of 44 patients with normal pancreas coexistent with malignant tumor of peripancreatic organs. The multi - slice spiral CT perfusion series were performed for pancreatic perfusion on a multi - slice CT scanner （Toshiba Aquilion 16）, at 120 kV, 200 mA, 1.0s/r, 4 × 2 collimation, interval ls, pitch 0. Contrast injection was done by using 50 ml contrast agent, at a flow rate of 6 ml/s with a power injector, and 6 seconds delay, the data acquisition lasted for 45 seconds. These data were processed on a Start Vitrea 2 workstation by using Toshiba body software package, and the mean blood flow （BF）, blood volume （BV）, permeability surface （PS）, mean transit time（MTT） were measured and statistically analyzed. Results： The mean BF, BV, PS and MTT of normal pancreas （Group A） were： （168.53±103.15） ml· 100g-1·min-1, （54.00±22.15） ml·100g-1, （196.38± 133.18） ml ·100g-1 ·min-1, （365.31 ±130.98） 0. 1s, respectively. The mean BF, BV , PS and MTT of normal pancreas coexistent with malignant tumor of peripancreatic organs（Group B） were （130.03± 66.58） ml·100g -1· min-1, （48.15 ±24.52）ml · 100g-1, （259.89 ± 206.66） ml·100g-1· min-1, （389.26 ± 207.63） 0. ls, respectively. The differences be- tween perfusion parameters in normal pancreas and normal pancreas coexistent with malignant tumor of peripancreatic organs were not statistically significant（P 〉 0.05）, which indicates blood supply of the normal pancreas and normal pancreas coexistent with malignant tumor of peripancreatic organs were the same. Conclusion： When tumor in the adjacent organs which have a close relationship with the blood circulation of the pancreas become malignant, the blood flow of the pancreas will not be influenced.