128层螺旋CT灌注成像在肾脏肿瘤诊断中的临床价值

Clinical application of the 128-slice spiral computed tomography perfusion imaging of renal tumor

目的研究128层螺旋CT肾脏灌注成像及后处理技术,探讨各项灌注参数对肾脏肿瘤病变诊断的临床应用价值。方法对20例肾脏正常患者及38例肾透明细胞癌、15例肾嫌色细胞癌及13例肾错构瘤患者行双肾平扫及灌注扫描,计算病灶感兴趣区(ROI)及正常肾皮质的时间-密度曲线(TDC)以及组织血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面渗透性(PS)等灌注指标,观察TDC曲线形态。结果正常肾皮质灌注值最高,恶性组最低,正常组与肾肿瘤各组间BF、BV及PS差异均有统计学意义(P<0.05),透明细胞癌与嫌色细胞癌组间差异无统计学意义(P>0.05)。结论多层螺旋CT灌注成像技术能较好地反映正常肾脏皮质及肾脏病变区的血流动力学变化,为肾癌的影像学诊断和鉴别诊断提供可靠依据,具有较高的临床价值。

Objective To investigate the scan methods and post-processing technology of 128-slice spiral CT, to investigate the various perfusion parameters on the clinical application of renal tumor＇s diagnosis. Methods Twenty normal healthy patients, 38 cases with suprarenal epithelioma and 15 cases with chromophobe renal cell car- cinoma which proved by operation and 13 cases with renal hamartoma, 128-slice spiral CT was used for renal perfu- sion scan following a standard non-enhanced scan. Calculate the time-density curve （TDC） and tissues blood flow （BF）, blood volume（BV）, mean transit time （MTI＇） and permeability surface （PS） to observe the sharp of TDC, to statistic a variety of perfusion parameters with analysis of variance. Results The group of normal renals＂ perfusion parameters have statistical differences to the group of renal tumors （P〈0.05）. Normal group is the highest, malignancy is the low- est. The renal clear cell carcinoma and the renal chromophobe cell carcinoma have no significantly statistical differ- ences （P〉0.05）. Conclusion CTPI technologies is helpful to assess tile blood flow and blood volume of renal cortex and renal lesions, It can provide a reliable basis for differential diagnosis ,which has important clinical application value.