多层螺旋CT评估肺腺癌血管生成可行性的初步研究

Preliminary feasibility assessment on the investigation of bronchogenic adenocarcinoma angiogenesis with dynamic multi-slice spiral computed tomography

目的 探讨多层螺旋CT(MSCT)评估肺腺癌血管生成的可行性。方法 对 2 7例肺腺癌(直径≤ 4cm)患者行MSCT动态增强增强 (以 4ml/s的流率注入对比剂 90ml)。用随机软件 (timelapse)计算主动脉及病灶强化值 (Apa) ,并计算肿瘤 主动脉强化值比率。用随机软件 (functionalCT)计算灌注值及平均通过时间 ,获取灌注值及平均通过时间图 ,并与文献结果对照。结果 肺腺癌强化值为 (36 6 6± 13 5 3)HU ,与文献的结果 (34 1HU)差异无显著性意义 (t=0 981,P =0 335 )。肿瘤 大动脉强化值比率 [(15 72± 4 6 6 ) % ]与文献的结果 (14 6 % )差异亦无显著性意义 (t =1 2 4 4 ,P =0 2 2 5 )。灌注值 (平均 3 2 78ml·min-1·kg-1)在单光子发射体层摄影 (SPECT)测量的肿瘤灌注值 (1 36～ 2 98ml·min-1·kg-1)范围内。平均通过时间为 (17 6 0± 4 5 2 )s。结论 MSCT研究肺腺癌血管生成是可行的。

Objective To evaluate the feasibility on the investigation of bronchogenic adenocarcinoma angiogenesis with dynamic multi-slice spiral computed tomography (MSCT). Methods 27 patients with bronchogenic adenocarcinomas (diameter ≤4 cm) underwent multi-location dynamic contrast material-enhanced (90 ml, 4 ml/s) serial CT. These dynamic images were processed with the “time lapse” software and the “functional CT” software. Peak heights of bronchogenic adenocarcinoma and the aorta, perfusion and mean transit time (MTT) were measured. Ratio of peak height of the bronchogenic adenocarcinoma to that of the aorta was calculated. Perfusion and mean transit time images were obtained. Results Peak height of bronchogenic adenocarcinoma was (36.66±13.53) HU. No statistically significant difference in the peak height was found between our results and the results of Ukihide et al (mean peak height 34.1 HU) ( t =0.981, P =0.335). Bronchogenic adenocarcinoma-to-aorta ratio was (15.72±4.66)%. The difference in bronchogenic adenocarcinoma -to-aorta ratio between our results and the results of Zhang and Kono (mean malignant SPN-to-aorta ratio 14.6%) did not reach statistical significance ( t =1.244, P =0.225). The mean perfusion value (3.278 ml·min -1 ·kg -1 ) was in the range of that (1.36～ 2.98 ml·min -1 ·kg -1 ) measured with a single photon emission CT(SPECT). Mean transit time was (17.60±4.52) s. Conclusion It is feasible to investigate bronchogenic adenocarcinoma angiogenesis with dynamic MSCT.