双源CT灌注参数评估胃癌生物学行为的诊断试验研究

The research of dual source CT perfusion parameter in biological behavior of gastric carcinoma

目的:探讨双源CT灌注参数BV、BF、Patlak P对胃癌生物学行为的评估价值。方法:使用双源CT对98例胃癌病人行灌注扫描,获得BF、BV、Patlak P值并以其对胃癌的生物学行为进行评估,以确定该灌注参数的评估价值。结果:双源CT灌注参数BF对无远隔转移组的诊断灵敏度为72.13%,特异度为64.52%,阳性预测值为81.67%,阴性预测值为52.63%,正确率为70.41%。BV对无远隔转移组的诊断灵敏度为68.66%,特异度为51.61%,阳性预测值为75.41%,阴性预测值为43.24%,正确率为63.27%。BV对癌组织局限于浆膜内的诊断灵敏度为60.00%,特异度为69.57%,阳性预测值为86.54%,阴性预测值为34.78%,正确率为62.24%。Patlak P值对癌组织局限于胃壁肌层内的诊断灵敏度为61.54%,特异度为75.86%,阳性预测值为69.57%,阴性预测值为68.75%,正确率为69.09%。Patlak P对癌组织突破浆膜的诊断诊断灵敏度为14.29%,特异度为69.23%,阳性预测值为60%,阴性预测值为20%,正确率为27.27%。结论:双源CT灌注参数BF、BV、Patlak P能够对胃癌的生物学行为进行评估,但仍有一定的局限性。

Objective： To investigate the value of dual source CT perfusion imaging parameters,including blood volume（BV）,blood flow（BF）,and Patlak P value in evaluating the biological behavior of gastric carcinoma.Methods： Dual source CT perfusion imaging was performed in 98 patients of gastric carcinoma.The BV,BF,Patlak P value were obtained to study the relationship between the parameters of perfusion and the biological behavior in gastric cancer,and estimate the value of parameters.Results： The BF could predict gastric carcinoma had no distant metastasis with a sensitivity of 72.13%,a specificity of 64.52%,a positive predictive value of 81.67%,a negative predictive value of 52.63%,and an accuracy of 70.41%.The BV could predict the gastric carcinoma had no distant metastasis with a sensitivity of 68.66%,a specificity of 51.61%,a positive predictive value of 75.41%,a negative predictive value of 43.24%,and an accuracy of 63.27%.The BV could predict gastric carcinoma confined within the serous membrane with a sensitivity of 60.00%,a specificity of 69.57%,a positive predictive value of 86.54%,a negative predictive value of 34.78%,and an accuracy of 62.24%.Patlak P value could predict the gastric carcinoma confined within the muscularis with a sensitivity of 61.54%,a specificity of 75.86%,a positive predictive value of 69.57%,a negative predictive value of 68.75%,and an accuracy of 69.09%.Patlak P value also could predict the gastric carcinoma had protrude beyond the serous membrane with a sensitivity of 14.29%,a specificity of 69.23%,a positive predictive value of 60%,a negative predictive value of 20%,and an accuracy of 27.27%.Conclusion： The dual source CT perfusion imaging parameters could assess the biological behavior of gastric carcinoma,but there still has limitations.