容积穿梭80mm CT灌注成像并动态CT血管成像在肾癌诊断中的应用

Utilization of Volume Shuttle 80mm CT Perfusion Imaging with Dynamic CT Angiography in Patients with Renal Carcinoma

目的探讨容积穿梭(VS)80mmCT灌注成像(CTP)并动态CT血管成像(CTA)在肾癌诊断中的应用价值。资料与方法 24例肾癌患者在64层螺旋CT上行VS80mmCTP检查,获得肿瘤和双肾实质血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)等灌注功能图像,同时获得80mm扫描覆盖范围内动态CTA图像。结果 24例肾癌患者均获得满意的80mmCTP图像和80mm动态CTA图像。CTP图像清楚显示了肾癌的灌注特征,瘤内高灌注区的BF值、BV值、PS值与同侧肾皮质比较,差异无统计学意义(P>0.05),但较对侧肾皮质显著降低(均P<0.01),MTT值与同侧肾皮质、对侧肾皮质比较,差异无统计学意义(P>0.05)。与同侧肾皮质、对侧肾皮质比较,瘤内低灌注区BF值、BV值、PS值显著降低,MTT值显著增高(均P<0.01)。肿瘤同侧肾皮质BF值、BV值、PS值显著低于对侧肾皮质(均P<0.01),MTT值差异无统计学意义(P>0.05)。CTA图像清楚显示双肾动脉和肿瘤新生血管的形态和血流动态变化。结论容积穿梭80mmCTP并动态CTA一次扫描可同时获得肾癌的血流动力学信息和肿瘤新生血管的形态学信息,有助于肾癌的诊断,是一种更为合理的扫描模式。

Purpose To investigate the value of volume shuttle （VS） 80mm CT perfusion （CTP） imaging simultaneously with dynamic CT angiography （CTA） in patients with renal carcinoma. Materials and Methods 24 patients with renal carcinoma underwent VS 80mm CTP using 64-slice spiral CT. The perfusion images of the tumor and bilateral kidneys were obtained, including blood flow （BF）, blood volume （BV）, mean transmit time （MTT） and permeability surface （PS）. The 80mm dynamic CTA were acquired at the same time. Results Satisfactory 80mm CTP and dynamic CTA images were obtained in all cases. The CTP images demonstrated the perfusion features of renal carcinoma. The BF, BV and PS values of intratumoral high-perfused area were not significantly different compared with those of ipsilateral renal cortex （P0.05）, but significantly lower than those of contralateral renal cortex （all P0.01）. The MTT value was not significantly different compared with that of ipsilateral and contralateral renal cortex （P0.05）. The BF, BV and PS value of intratumoral low-perfused area were significantly lower but the MTT value was significantly higher than those of ipsilateral and contralateral renal cortex（all P0.01）. The BF, BV and PS values of ipsilateral renal cortex were significantly lower than those of contralateral renal cortex（all P0.01）, but the MTT value was not significantly different between ipsilateral and contralateral renal cortex （P0.05）. The CTA images showed the shape and dynamic changes of blood flow in bilateral renal artery and the tumor vessels. Conclusion Volume shuttle 80mm CTP simultaneously with dynamic CTA provide hemodynamic information of the tumor and morphological information of tumor vessels and help diagnose renal carcinoma. This suggests an ideal scanning mode.