能谱CT评价射频消融治疗非小细胞肺癌的早期疗效

CT spectral imaging evaluation of early efficacy of radiofrequency ablation in treatment of non-small cell lung cancer

目的探讨CT宝石能谱成像(GSI)在射频消融治疗非小细胞肺癌(NSCLC)早期疗效评价中的应用价值。方法收集经临床和病理证实的NSCLC患者20例,其中腺癌12例,鳞癌8例。于射频消融治疗前和治疗后早期(<1个月)进行能谱CT扫描,获得肺动脉期图像,并进行图像重建,得到碘基物质图像、水基物质图像、70 keV水平的单能量CT值及能谱曲线斜率,并对治疗前后进行对比分析。结果 20例患者病灶射频消融治疗后的碘(水)基含量、70 keV水平CT值、能谱曲线斜率明显低于治疗前,水(碘)基含量略高于治疗前,差异均有统计学意义(P均<0.05)。结论 GSI可反映NSCLC射频消融治疗前后病灶的血供特点及灌注程度变化,有助于评价射频消融治疗NSCLC的早期疗效。

Objective To evaluate the value of gemstone spectral imaging（GSI） in early evaluation of emcacy of radiofrequency ablation（RFA） therapy of non-small cell lung cancer（NSCLC）.Methods Twenty patients with NSCLC were confirmed by clinic and pathology,which included 12 cases of adenocarcinoma,8 cases of squamous carcinoma.All the patients were preformed GSI respectively before treatment and early after treatment（〈1 month）.By using images of the pulmonary artery phase and GSI viewer reconstruction software,the images were reconstructed.The iodine-substance images,water-based image,70 keV energy CT value and energy spectrum curve slope were acquired,and the differences of these parameters before and after treatment were statistically analyzed.Results The iodine（water） content,70 keV energy CT value and energy spectrum curve slope of the lesions after RFA treatment were lower than those before treatment,and water（iodine） content was slightly higher than that of before treatment,the differences were all statistically significant（all P〈0.05）.Conclusion GSI can reflect changes of blood supply and perfusion degree of NSCLC before and after RFA therapy,which is heloful to evaluating the early efficacy of radiofrequency ablation in the treatment of NSCLC.