贲门癌多模态CT灌注成像研究

Study of Multi-model perfusion CT imaging of cardia cancer

目的分析多模态CT灌注成像与影响贲门癌预后的病理因素之间的关系,探讨其评估贲门癌预后的价值。方法搜集35例具有明确病理和完整临床资料的贲门癌患者行64层螺旋CT全胃灌注成像,分析灌注值(perfusion,PF)、强化峰值(peak enhancement intensity,PEI)、达峰时间(time to peak,TTP)、血容量(blood volume,BV)与肿瘤分化程度、TNM分期、浆膜浸润及淋巴结转移间的关系。结果贲门癌PF、PEI、TTP和BV值分别为(65.78±30.12)ml/(100ml·min)、(36.45±11.27)HU、(18.33±8.66)s和(22.36±5.37)ml/100g。高、中分化组与低分化组组间PF值差异具有统计学意义(P<0.05),分化程度低,PF值越大。与中、高分化组比较,低分化组PEI较大,而TTP值较短,且差异均有统计学意义(P<0.05)。PF、PEI、TTP及BV值与TNM分期、浆膜浸润、淋巴结转移无明显相关(P>0.05)。结论多模态CT灌注参数PF、PEI及TTP与贲门癌分化程度有关,尤以PF值价值最高,可以为临床评估预后提供有价值信息。

Objective To explore the relationship between multi-model CT perfusion parameters of cardia cancer and prognostic factors （tumor differentiation degree, TNM stating, serosal invasion, lymph nodes metastasis）. Methods Whole stomach CT perfusion imaging was performed on 35 patients with cardia cancer. The cardia cancer on perfusion parameters such as PF, PEI, TTP, and BV were caculated. We analyzed the relationship between CT perfusion parameters and prognostic factors （tumor differentiation degree, TNM stating, serosal invasion, lymph nodes metastasis）. Results The PF, PEI, TTP and BV values of cardia cancer were （65.78±30.12） ml/ （100ml·min）, （36.45±11.27） HU, （18.33±8.66） s, and （22.36±5.37） ml/100g, respectively. The PF of the three different differentiation groups all had statistical significance. The PEI of the poorly group was greater than that of the moderately and well group’s. But the TTP of the poorly group was smaller than that of the moderately and well group’s. The PF, PEI, TTP and BV of cardia cancer did not have the relationship with the TNM stating, serosal invasion and the metastasis of the lymph nodes （ P 〉0.05）. Conclusion The PF, PEI and TTP are the meaningful indicator of multi-model CT perfusion parameter especially PF value, which have relationship with differentiated degree. These could provide useful information for prognostic evaluation.