多层螺旋CT灌注成像在胃癌术前评估中的应用

Preoperative Assessment of Multi-slice CT Perfusion Imaging in Gastric Cancer

目的探讨多层螺旋CT(MSCT)进行胃癌灌注成像的可行性,评价其在胃癌术前评估中的应用价值。资料与方法 67例经胃镜证实的胃癌患者行MSCT灌注成像扫描,计算肿瘤感兴趣区的灌注参数,包括血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)。分析胃癌细胞分化程度、临床分期、病理分期、淋巴结转移、远处转移及转移部位与各灌注参数的关系。结果 PS值在胃癌不同细胞分化程度、TNM分期、病理分期、有无淋巴结转移、有无远处转移各组间差异有统计学意义(P<0.05),MTT值在胃癌各组间差异均无统计学意义(P>0.05),BF、BV在不同TNM分期组间差异有统计学意义(P<0.05),BF在病理分期组间差异有统计学意义(P<0.05)。结论 MSCT灌注成像能反映胃癌的血流动力学变化,对胃癌的术前评估有重要意义。

Purpose To explore the feasibility of CT perfusion in gastric cancer using multi-slice CT （MSCT） scanner, and to evaluate the value of CT perfusion parameters in preoperative assessment of gastric cancer. Materials and Methods MSCT perfusion imaging was preoperatively performed in 67 patients with gastric cancer confirmed by gastroscope. The CT hemodynamic parameters in regions of interest （ROI） including blood flow （BF）, blood volume （BV）, mean transit time （MTT） and permeability surface （PS） were measured. The relationships of the perfusion parameters and degree of tumor cells, TNM staging, pathology staging, the metastasis of the lymph node and distant metastasis were analyzed. Resullts There was significant difference in PS value among lymphatic involvement （P 〈 0.05）, differentiation degree （P〈0.05）, TNM staging （P〈 0.05）, pathology staging （P 〈 0.05） and distant metastasis （P〈 0.05）. However, there was no statistic difference in MTT value among the three groups （P 〉 0.05）. There was statistic differences of BV and BF in different TNM stagings （P〈 0.05）. There was statistic difference of BF for different pathology stagings （P 〈 0.05）. Conclusion MSCT perfusion imaging can reflect the hemodynamic changes of gastric cancer, which provides important clinical value for preoperative evaluation.