CT灌注成像参数对胃腺癌恶化程度的评估价值

Value of CT perfusion imaging parameters on assessing the deteriorated degree of gastric adenocalinoma

目的探究CT灌注成像参数与胃腺癌患者恶化程度的相关性。方法选取108例胃腺癌患者作为研究对象。根据病理结果的肿瘤细胞分化程度,将38例低分化腺癌纳入低分化腺癌组,30例高分化腺癌纳入高分化腺癌组,并选择同期40例非胃腺癌患者作为对照组。所有患者均通过双源CT进行灌注扫描,获得时间最大密度投影、平均图像、血容量、血流量、patlak血管通透性、patlak血容量、patlak R平方图、patlak残差图等灌注参数,并分析CT灌注成像参数与胃腺癌患者恶化程度的关系。结果三组间的时间最大密度投影、血容量、平均图像、血流量、patlak血管通透性比较,差异均有统计学意义(F分别=5.66、5.44、6.05、5.88、6.22,P均<0.05)。高分化腺癌组患者的时间最大密度投影、血容量、平均图像、血流量、patlak血管通透性均高于低分化腺癌组和对照组,差异均有统计学意义(t分别=2.15、2.23、2.36、2.12、2.13;2.25、2.37、2.65、2.30、2.24,P均<0.05)。Pearson相关性分析显示,平均图像、血容量、血流量三项指数与胃腺癌的恶化程度呈正相关(r分别=0.84、0.83、0.91,P均<0.05),时间最大密度投影和patlak血管通透性两项指数与胃腺癌的恶化程度不相关(r分别=0.21、0.25,P均>0.05)。结论 CT灌注成像参数时间平均图像、血容量、血流量等指标能够有效评估胃腺癌患者的恶化程度。

Objective To investigate the correlation between CT perfusion imaging parameters and deteriorated de-gree of gastric adenocalinoma patients. Methods A total of 108 patients with gastric adenocalinoma were selected.According to the degree of tumor cell differentiation,38 cases of poorly differentiated adenocarcinoma were enrolled as a low differentiated adenocarcinoma group,and 30 cases of highly differentiated adenocarcinoma were enrolled as a highly differentiated adenocarcinoma group. 40 cases of patients with non gastric adenocalinoma patients were se-lected as the control group at meanwhile. All patients were treated by perfusion of dual source CT. The time of maximum intensity projection,the average maximum intensity projection images,blood volume,blood flow,patlak vascular permeability,patlak blood volume,patlak R,patlak square residual plot perfusion and the relationship between the deteriorated degree of gastric cancer and CT perfusion parameters were observed and analyzed. Results The time of maximum intensity projection,blood volume,the average maximum intensity projection images,blood flow,patlak vascular permeability among three groups were significantly different（F= 5.66,5.44,6.05,5.88,6.22,P〈0.05）. The time of maximum intensity projection,blood volume,the average maximum intensity projection images,blood flow and patlak vascular permeability of high differentiated adenocarcinoma group were significantly higher than those of low differentiated adenocarcinoma group and control group（t =2.15,2.23,2.36,2.12,2.13,2.25,2.37,2.65,2.30,2.24,P〈0.05）.Pearson correlation related analysis showed that the average maximum intensity projection images,blood volume,blood flow were positively associated with the deteriorated degree of gastric cancer（r = 0.84,0.83,0.91,P 〈0.05）,while the time of maximum intensity projection and patlak vascular permeability were not associated with the deteriorated degree of gastric cancer（r = 0.21,0.25,P 〉0.05）. Conclusion CT perfusion imaging parameters as the time of maximum intensity projection,blood volume,blood flow can effectively assess the deteriorated degree of gastric adeno-calinoma.