多层螺旋CT灌注成像对肺癌化疗效果的临床评价研究

Study on the Clinical Curative Effect Evaluation of Multi-slice Spiral CT Perfusion Imaging in Lung Cancer Chemotherapy

目的探讨肺癌化疗前后灌注参数值的改变,评估CT灌注成像在肺癌化疗疗效评价中的价值。方法2013年1月至2013年12月选取符合标准的患者30例,分析其化疗效果和化疗前后CT灌注成像参数值的变化。结果30例患者完成2个周期化疗后PR 2例、CR 10例、SD 13例和PD 5例。化疗前有效组患者BF值高于无效组,差异有统计学意义(P<0.05);而二者BV、MTT及PS比较,差异无统计学意义(P>0.05)。有效组患者化疗后BF值下降、MTT值升高,较治疗前差异均有统计学意义(P<0.05),而BV和PS值治疗前后变化不大,差异无统计学意义(P>0.05)。无效组患者化疗前后BF、BV、MTT和PS值变化不大,差异无统计学意义(P>0.05)。结论 CT灌注成像能够反映非小细胞肺癌的血供情况,化疗前高血流量状态及化疗后平均通过时间升高提示其对化疗反应相对敏感,近期疗效好,缓解率高。

Objective To discuss the change of perfusion parameters before and after lung cancer chemotherapy, evaluate the value of CT perfusion imaging in lung cancer chemotherapy curative effect evaluation. Methods 30 cases meeted a criterion from January to February 2013, which of chemotherapy effect and CT perfusion parameters were analysed before and after chemotherapy. Results After two cycles of chemotherapy, there were 2 cases with PR, 10 cases with CR, 13 cases with SD, 5 cases with PD in 30 patients. Before chemotherapy BF value in effective group was higher than the invalid group, and the difference was statistically significant （P 〈 0. 05 ） ; and BV, MTT and PS value in two group had no significant difference（ P 〉 0. 05 ）. Compared with before treatment, BF value descended and MTT value elevated in effective group （P 〈 0. 05 ） ; And BV and PS value had no significant difference（P 〉0.05）. BF, BV, MTT and PS value had no significant difference in valid group before and after treatment （ P 〉 0. 05 ）. Conclusion CT perfusion imaging can reflect blood supply of non-small cell lung cancer, high blood flow state before chemotherapy and the rise in the average through time after chemotherapy illustrated that it was sensitive to chemotherapy, good curative effect, remission rate.