肺癌患者治疗前后的CT影像学变化

CT Imaging Changes in Patients with Lung Cancer before and after Treatment

目的探讨肺癌患者治疗前后的CT影像学变化。方法选取2015年8月至2017年5月在北京市昌平区中医医院初治的原发性肺癌患者68例为研究对象,经病理检验证实均接受放化疗,分别于治疗前、治疗后3个月对患者行CT灌注扫描检查,根据实体瘤的疗效评价标准(RECIST)对治疗效果予以判定,观察患者相关影像学变化。结果 68例患者均于治疗3个月后观察疗效,有效47例(其中完全缓解15例,部分缓解32例),无效21例(其中稳定13例,进展8例),有效率为69.12%。68例患者治疗后达峰时间较治疗前长[(23.49±3.87)s比(20.95±3.68)s],血容量、灌注值及强化幅度较治疗前比明显降低[(9.76±2.08)m L/100 g比(16.83±3.15)m L/100 g,(16.36±2.85)m L/(min·100 g)比(24.21±4.06)m L/(min·100 g),(19.46±3.79)Hu比(30.17±4.82)Hu](P<0.01)。结论 CT灌注扫描检查相关影像学指标可反映肺癌患者肿瘤血供情况,使临床治疗方案进一步优化。

Objective To investigate CT imaging changes in patients with lung cancer before and after treatment.Methods From Aug. 2015 to May 2017,68 patients with primary lung cancer who were initially treated in Changping District Hospital of Traditional Chinese Medicine were selected as the study objects.The pathological examination confirmed that they all received radiotherapy and chemotherapy. CT perfusion scan was performed on the patient before treatment and after 3 months of treatment.The therapeutic effect was judged according to RECIST criteria,and the related imaging changes were observed. Results The curative effect was observed in 68 cases after 3 months of treatment,47 cases were effective（including 15 cases of complete remission,32 cases of partial remission）,and 21 cases were invalid（13 cases stable, 8 cases progress）.The effective rate was 69.12%.The peak time after treatment in 68 patients was significantly longer than that before treatment[（23.49±3.87） s vs （20.95±3.68） s],and the blood volume,perfusion value and enhancement amplitude were significantly lower than those before treatment[（9.76±2.08） mL/100 g vs （16.83±3.15） mL/100 g,（16.36±2.85） mL/（min·100 g） vs （24.21±4.06） mL/（min·100 g）,（19.46±3.79） Hu vs （30.17± 4.82） Hu ]（ P 〈0.01）. Conclusion CT perfusion imaging can reflect the blood supply of patients with lung cancer,which can help to further optimize the clinical treatment plan.