64层螺旋CT灌注成像在对喉鳞状细胞癌放化疗后病情的评估价值的研究

The assessed value of 64 slice spiral CT perfusion imaging in laryngeal squamous cell carcinoma after chemotherapy and radiotherapy

目的:探讨64层螺旋CT灌注成像对喉鳞状细胞癌放化疗后病情评估的价值。方法:对45例局部晚期喉鳞状细胞癌患者均分别在治疗前和放疗剂量达40Gy时行常规CT增强扫描和CT灌注成像检查,并同时测量血流量、血容量、平均通过时间和表面通透性,再根据末次检查时肿瘤体积减小的百分率将患者分为敏感组及非敏感组,并将各项肿瘤灌注指标进行对比。结果:敏感组在放疗剂量达40Gy时血流量、血容量、表面通透性均较治疗前降低,而非敏感组均上升(P<0.05);血流量、血容量、平均通过时间、表面通透性等参数ROC曲线下面积分别为0.804、0.843、0.852、0.826,血流量敏感性、特异性和准确性分别为89.7%、86.8%和90.9%,血容量为100.0%、91.4%和93.7%,平均通过时间为100.0%、67.7%和88.3%,表面通透性为91.2%、69.4%和90.6%(均P<0.01)。结论:64层螺旋CT灌注成像检查对于喉鳞状细胞癌患者放化疗后病情有较好的评估价值。

Objective：To study the assessed value of 64 slice spiral CT perfusion imaging （CTPI） in laryngeal squamous cell carcinoma after chemotherapy and radiotherapy. Method：Forty five patients diagnosed with local advanced laryngeal squamous cell carcinoma were selected. Conventional CT and CTPI were performed before treatment and at the time of radiation close up to 40 Gy. Blood flow, blood volume, mean transit time and surface per- meability were measured at the same time. According to the decrease of tumor volume in final examination, patients were divided into sensitive group and insensitive group. The tumor perfusion indexes were compared between groups. Result： Blood flow, blood volume, surface permeability after 40Gy treatment were lower than before treatment in both sensitive group and the insensitive group ascended（P〈0.05）. The AUC of ROC of blood flow, blood volume, mean transit time and surface permeability were 0. 804, 0. 843, 0. 852 and 0. 826. The sensitivity, specificity and accuracy of blood flow was 89.7%, 86.8% and 90.9%. There were 100.0%, 91.4% and 93.7% in blood volume; 100.0%, 67.7% and 88.3% in mean transit time; 91.2%, 69.4% and 90.6% in surface per-meability（P〈0.01）. Conclusion：Sixty-four slice spiral CT perfusion imaging is able to assess tumor status of laryngeal squamous cell carcinoma after chemotherapy and radiotherapy effectively.