肾癌伴静脉癌栓患者肾皮质的320排CT灌注研究

320-Slice CT Perfusion Imaging Characteristics of Renal Cortex in Patients with Renal Cell Carcinoma Associated with Thrombus in Renal Vein and Inferior Vena Cava

目的应用320排容积CT体部灌注成像技术研究肾癌伴静脉癌栓患者肾脏皮质的灌注特征。方法回顾性分析50例肾癌患者的320排CT灌注图像,其中43例肾癌直径<4 cm(<4 cm组),7例肾癌伴静脉癌栓(癌栓组);统计分析肾皮质灌注参数,包括等效血容量、清除率、血流量。结果 <4 cm组健患侧肾皮质间灌注参数的差异无统计学意义(P>0.05);癌栓组健患侧肾皮质间灌注参数的差异有统计学意义(P<0.05)。<4 cm组与癌栓组健侧肾皮质间灌注参数的差异无统计学意义(P>0.05)。结论 320排CT灌注成像能定量评价肾癌伴静脉癌栓患者肾脏皮质的生理功能特点,在肾癌的临床治疗及预后评估方面具有一定的价值。

Objective To study the perfusion imaging characteristics of normal renal cortex in renal cell carcinoma （RCC） patients associated with thrombus in the renal vein and inferior vena cava by using 320-slice dynamic volume CT scanning. Methods 320-slice CT perfusion images of 50 RCC patients were retrospectively reviewed. Of the 50 patients, the lesion with 〈4cm diameter was seen in 43 （ 〈4 cm group） , and thrombus in the renal vein and inferior vena cava was found in 7 （thrombus group）. The renal perfusion parameters, including equivalent blood volume （Equiv BV）, clearance and blood flow （BF） of the normal renal cortex were measured, and the results were statistically analyzed. Results In the 〈 4 cm group the differences in the mean Equiv BV, clearance and BF of the renal cortex between the healthy side kid- ney and the disease side kidney were of no statistical significance （P 〉 0.05）, while in the thrombus group the differences in the perfusion parameters between the healthy side kidney and the disease side kidney were statistically significant （P 〈 0.05）. No significant differences in the perfusion parameters of normal renal cortex existed between the 〈 4cm group and the thrombus group （ P 〉 0.05）. Conclusion 320-slice dynamic volume CT scanning can quantitatively evaluate the physiological functions of normal renal cortex in RRC patients with thrombus in vein. This technique has certain value in planning the clinical treatment and in evaluating the prognosis the 〈 4 cm group the differences in the mean Equiv BV, clearance and BF of the renal cortex between the healthy side kid- ney and the disease side kidney were of no statistical significance （ P 〉 0.05 ）, while in the thrombus group the differences in the perfusion parameters between the healthy side kidney and the disease side kidney were statistically significant （ P 〈 0.05 ）. No significant differences in the perfusion parameters of normal renal cortex existed between the 〈 4cm group and the thrombus group （ P 〉 0.05 ）. Conclusion 320-slice dynamic volume CT scanning can quantitatively evaluate the physiological functions of normal renal cortex in RRC patients with thrombus in vein. This technique has certain value in planning the clinical treatment and in evaluating the prognosis