双源CT灌注扫描对胰腺癌诊断的应用价值

The value of CT perfusion in diagnosis of pancreatic cancer

目的探讨CT灌注对胰腺癌诊断的应用价值。方法采用Siemens双源CT扫描仪,对104例临床怀疑为胰腺癌或经超声检查发现胰腺占位性病变者进行CT灌注检查。比较胰腺癌组织与周围正常组织间各灌注参数值差异,比较常规增强CT方法及其与CT灌注相结合对于胰腺癌的检出率。结果经手术病理或临床检查证实73例为胰腺癌。胰腺癌组织的灌注参数值血流量(Flow),血容量(blood volume,BV),通透性(permeability,per)及Patlak血流量(patlak blood volume,pBV)分别为(68.34±30.06)ml·(100ml)-1·min-1,(112.75±39.57):1000,(64.14±27.28)0.5ml·(100ml)-1·min-1,(56.87±32.62):1000,均较周围正常胰腺组织低(P<0.05)。CT灌注方法结合常规增强CT检查具有较高的敏感度(98.6%)、特异度(90.3%)、阳性预测值(96.0%)、阴性预测值(96.5%)及准确度(96.2%)。结论胰腺CT灌注方法能够定量反映胰腺癌低血供的特点,结合常规增强CT可提高胰腺癌的诊断能力。

Objective To evaluate the perfusion features of pancreatic cancer and the clinical value of perfusion CT in diagnosis.Methods Perfusion CT was performed in 104 patients who were suspected as pancreatic cancer with a 64-slice CT using a dynamic sequence after contrast-enhanced CT.Compare the perfusion parameters between cancer tissue and peripheral healthy tissue.Analyze the diagnostic accuracies between the perfusion CT combined with routine CT and single routine CT method.Results Seventy three patients were confirmed as pancreatic cancer by histopathologic examination or follow-up.The perfusion parameters of lesion were lower than that of peripheral healthy tissue,and the values of Flow,BV and pBV had significant differences （P 〈 0.05）.The perfusion CT combining with contrast-enhanced CT had a higher susceptibility （98.6%）,specificity （90.3%）,positive predictive value（96.0%）,negative predictive value（96.5%）and accuracy（96.2%）than contrast-enhanced CT.Conclusions CT perfusion could reflect the feature of low blood supply of pancreatic cancer.It could improve the diagnostic capability of pancreatic cancer.