宫颈鳞癌容积CT灌注参数的测量稳定性和影响因素

Measurement Stability and Influencing Factors of Volume CT Perfusion Parameters of Cervical Squamous Carcinoma

目的探讨宫颈鳞癌容积CT灌注参数的测量稳定性和影响因素。资料与方法对43例宫颈鳞癌患者行全子宫容积CT灌注扫描,2名医师分别对灌注图像的宫颈鳞癌和正常宫体动脉血流量(AF)、血容量(BV)、表面渗透性(PS)、髂外动脉AF、臀大肌AF、臀大肌CT和臀部脂肪层CT值进行测量,并采用组内相关系数(ICC)评价测量结果的一致性。比较鳞癌与宫体各参数值的差异以及未绝经与绝经患者间鳞癌和宫体各参数值的差异,分析宫颈鳞癌灌注参数与相关因素的相关性。结果 2名医师间各参数测量结果的ICC值为0.759~0.988,一致性良好;鳞癌AF[(179.4±51.8)ml/(min·100 g)]高于宫体AF值[(151.2±48.7)ml/(min·100 g)];除鳞癌BV值外,宫颈鳞癌及宫体各参数值在未绝经与绝经患者间差异有统计学意义(P<0.05);除宫颈鳞癌BV值外,宫颈鳞癌及正常宫体各灌注参数与患者年龄呈负相关(r=-0.550^-0.424,P<0.05);宫颈鳞癌AF值与正常宫体AF值呈正相关(r=0.520,P<0.05)。结论容积CT灌注成像参数评价宫颈鳞癌具有很好的稳定性,宫颈鳞癌血流量较宫体丰富;年龄、月经状态是影响鳞癌及宫体血供的因素。

Purpose To investigate the measurement stability and influencing factors of volume CT perfusion parameters of cervical squamous carcinoma.Materials and Methods Forty-three patients with cervical squamous carcinoma underwent CT perfusion scan.Artery flow(AF),blood volume(BV),permeability surface(PS),external iliac artery AF,gluteus maximus AF,gluteus maximus CT and hip fat layer CT value of cervical squamous carcinoma with perfusion images and normal uterus were measured respectively by two physicians.The consistency of measurement results was evaluated using intra-group correlation coefficient(ICC).The differences between parameters of squamous carcinoma and uterus were compared,and the differences between parameters of squamous carcinoma and uterus of non-menopausal and postmenopausal patients were also compared;the correlation between perfusion parameters and related factors of squamous carcinoma were analyzed.Results ICC values of parameters measured by two physicians were 0.759-0.988,denoting good consistency;squamous carcinoma AF[(179.4±51.8)ml/(min·100 g)]was higher than AF value of uterus[(151.2±48.7)ml/(min·100 g)];besides BV value of squamous carcinoma,the difference between parameters of cervical squamous carcinoma and that of uterus for nonmenopausal and postmenopausal patients were statistically different(P<0.05);besides BV values of cervical squamous carcinoma,parameters of cervical squamous carcinoma and that of normal uterus were negatively correlated with patient's age(r=-0.550--0.424,P<0.05);AF value of cervical squamous carcinoma was positively correlated with normal uterus(r=0.520,P<0.05).Conclusion The parameters of volume CT perfusion imaging have good stability in evaluation of cervical squamous carcinoma,and the blood flow volume of cervical carcinoma is more affluent compared with that of uterus;age and menstrual status are the factors affecting squamous carcinoma and uterine blood supply.