多层螺旋CT在非小细胞肺癌患者化疗效果评估中的应用价值

The application value of MSCT in the evaluation of chemotherapy effect in patients with non-small cell lung cancer

目的研究多层螺旋CT(MSCT)在非小细胞肺癌(NSCLC)患者化疗效果评估中的应用价值。方法纳入NSCLC患者64例,所有患者均于化疗前后进行MSCT检查。根据患者的化疗效果分为缓解组和未缓解组,比较2组患者化疗前后的MSCT相关指标。使用Pearson检验分析肿瘤长径、CT值的变化率与MSCT灌注成像指标变化率的相关性。使用受试者工作特征(ROC)曲线分析MSCT指标在NSCLC患者化疗效果预测中的应用价值。结果NSCLC患者化疗后,治疗缓解患者29例,未缓解患者35例。化疗前,缓解组血流量(BF)值高于未缓解组,差异具有统计学意义(P<0.05)。化疗后,缓解组肿瘤长径、CT值、血容量(BV)、BF、表面渗透性(PS)下降,对比剂通过时间(MTT)、强化峰值(PEI)增加,且均优于未缓解组,差异均具有统计学意义(P<0.05)。NSCLC患者化疗后肿瘤长径和CT值的变化率与BV、MTT、PEI、BF、PS均具有明显的相关性(P<0.05)。BF在NSCLC患者化疗效果预测的曲线下面积(AUC)为0.725(95%CI:0.593,0.857)。结论MSCT下BV、MTT、PEI、BF、PS的变化均与NSCLC患者肿瘤长径、CT值相关,其中化疗前BF值可作为NSCLC患者化疗效果预测的有效指标。

Objective The application value of multi-slice spiral CT(MSCT)in the evaluation of chemotherapy effect in patients with non-small cell lung cancer(NSCLC)was analyzed.Methods A total of 64 patients with NSCLC were included,and all patients underwent MSCT examination before and after chemotherapy.According to the chemotherapy effect,the patients were divided into remission group and non-remission group,and the MSCT-related indexes before and after chemotherapy were compared between the two groups.The Pearson test was used to analyze the correlation between the tumor length,the change rate of CT value and the change rate of MSCT perfusion imaging indexes.The receiver operator characteristic(ROC)curve was used to analyze the application value of MSCT indicators in the prediction of chemotherapy effect in patients with NSCLC.Results After chemotherapy in NSCLC patients,29 patients were in remission and 35 patients were not in remission.Before chemotherapy,the blood transit flow(BF)value of the remission group was higher than that of the non-remission group,and the difference was statistically significant(P<0.05).After chemotherapy,the tumor length,CT value,blood volume(BV),BF,and PS of the remission group decreased,while mean transit time(MTT)and PEI increased,which were all better than those of the non-remission group,and the differences were statistically significant(P<0.05).The changes of tumor length and CT value in NSCLC patients after chemotherapy were significantly correlated with BV,MTT,PEI,BF,and PS(P<0.05).The area under the curve(AUC)of BF for predicting chemotherapy effect in NSCLC patients was 0.725(95%CI:0.593-0.857).Conclusion The changes of BV,MTT,PEI,BF,and PS under MSCT were all related to the tumor length and CT value of NSCLC patients,and the BF value before chemotherapy could be used as an effective indicator to predict the chemotherapy effect of NSCLC patients.