动态容积CT在宫颈癌全器官灌注中可行性的初步研究

Whole organ perfusion of the cervix using dynamic volume CT in patients with cervical cancer acquisition technique post processing and initial results

目的旨在探讨640层CT在宫颈癌全器官灌注中的应用价值以及正常宫颈组织和宫颈癌的CT灌注特征。方法对12例经病理证实的宫颈癌患者行320层CT灌注扫描。经肘静脉高压团注对比剂(7ml/s,350mg/ml),监测腹主动脉CT值自动触发行全子宫CT灌注扫描。用图像对位(Body registration)技术处理原始容积数据包,然后用体部灌注(Body Perfusion)软件进行图像和数据后处理。对正常宫颈组织和宫颈癌的CT灌注数据进行统计学分析。结果 12例宫颈癌患者全子宫完整显示,所有患者完成原始图像对位。宫颈癌的时间-密度曲线(TDC)均呈速升型。在灌注图上,宫颈癌显示清晰,与正常宫颈组织相比灌注明显增高,宫颈癌的血容量(AF)(255.42±28.14)ml/min/100ml明显高于正常宫颈组织的AF(168.34±7.49)ml/min/100ml(t值为3.189,P<0.05)。结论 640层CT的宫颈癌动态容积CT灌注具有良好的可操作性和可行性。CT灌注作为综合评价宫颈癌的一种影像学手段,可很好评价病灶的血流动力学改变,是常规CT扫描的有益补充。

Objective To evaluate the application value of whole-organ CT perfusion in the assessment of cervical cancer using the 640-slice CT, and the CT perfusion manifestation of normal tissue and cervical cancer. Methods Twelve histologically proven cervical cancer patients underwent CT perfusion study using a 640-slice CT unit. Abdominal aortic CT value was monitored and automatically triggersed whole-organ CT perfusion scan following contrast-material injection （7 ml/ s, 350 mg iodine/ml）. After image registration, perfusion was determined with the gradient relationship technique and volume regions-of-interest were defined for perfusion measurements. Contrast time-density curves and perfusion maps were generated. Statistical analysis was performed using the t test for analysis perfusion value of the normal tissue and the cervical cancer. Results In all 12 patients, the entire uterus was imaged, and registration could be completed in all cases. The time-density curve ascended quickly. The cervical cancer could be visualized on color maps, and was significantly higher than the surrounding normal tissue. The AF of cervix cancer （255.42±28. 14） ml/min/100ml was significantly higher than that of normal tissue （168.34±7.49） ml/min/100ml （ t =3. 189, P d0.05）, and could be visualized on colored perfusion maps. Conclusion The 640-slice CT cervical cancer dynamic volume CT perfusion has good maneuver ability and feasibility. As a comprehensive imaging technique in the evaluation of cervical cancer, CT perfusion can evaluate the hemodynamic changes of cervical cancer and is a useful complement to conventional CT scan.