CT灌注成像在食管癌中的应用

Application of CT perfusion in esophageal carcinoma

目的:总结国内外CT灌注技术及其在食管癌中的应用进展。方法:应用Medline和CNKI期刊全文数据库系统,以"食管癌、计算机体层成像、灌注"为关键词,检索1991-01—2010-01的相关文献,共检索到英文文献61篇和中文文献11篇。纳入标准:1)CT灌注技术的理论基础;2)食管癌灌注参数的意义;3)CT灌注在食管癌诊断、治疗中的价值。根据纳入标准分析24篇文献。结果:1)食管癌CT灌注参数血容量(BV)和峰值到达时间(TTP)与食管癌微循环情况有良好相关性;2)放疗前后的食管癌CT灌注参数毛细血管通透性(PS)、强化峰值(PEI)有显著差异;3)食管癌患者对放化疗的敏感性及治疗效果与CT灌注参数显著相关,对放化疗敏感的患者其灌注参数BV、血流量(BF)高于不敏感者,而MTT短于不敏感者;4)CT灌注可以对局部和远处转移的食管癌进行检测和分期。结论:CT灌注技术可以评价血管生成情况,对食管癌具有诊断价值;也可以评价和预测放化疗疗效,辅助食管癌治疗;同时,CT灌注还是食管癌分期的一种新方法。

OBJECTIVE：To sum up the domestic and abroad articles correlated with the development of CT perfusion in esophageal carcinoma.METHODS：＂esophageal carcinoma,CT,perfusion＂were searched as key words by Medline and CNKI series full-text detabases retrieval system from 01-1991 to 01-2010.Totally 61 English papers and 11 Chinese papers were obtained.Choice criteria： 1） Theoretical basis of CT perfusion.2）Significance of CT perfusion parameters.3）Value of CT perfusion in diagnosis and therapy of esophageal carcinoma.By extraction of the choice criteria,24 closely related papers are selected.RESULTS： 1）CT perfusion parameters such as BV（bold volume） and TTP（time to peak） are positively correlated with microvessel density（MVD） of esophageal carcinoma.2）PS（permeability surface） and PEI（peak enhancement intensity） are significantly deviated before and after radiotherapy.3）BV and BF（blood flow） are positively correlate and MTT is negtively correlated with sensitivity of patients to radiotherapy and chemotherapy.4） CT perfusion can be used in locoregional and distant disease detection and staging.CONCLUSIONS： CT perfusion takes an important part in assessing angiogenesis of esophageal carcinoma and in predicting the response to radiotherapy and chemotherapy.In addition,CT perfusion is a new method for locoregional and distant disease detection and staging.