CT灌注成像在股骨头缺血性坏死中的应用效果及对疾病分期的检测价值

目的探讨CT灌注成像在股骨头缺血性坏死中的应用效果及对疾病分期的检测价值。方法选取苏州大学附属第二医院影像科2019年1月至2020年10月治疗的86例股骨头缺血性坏死的患者,对患者分别进行CT灌注成像和X线检查,比较2种方法的早期检出率和总确诊率,以及2种方法检查出股骨头坏死早期征象的阳性情况。结果CT灌注成像、X线在Ficat分期中的早期检出率分别为58.1%(50/86)、43.0%(50/86),确诊率分别为91.9%(79/86)、70.9%(61/86),差异均有统计学意义,(P<0.05);ARCO分期中早期检出率分别为54.6%(47/86)、43.0%(37/86),确诊率分别为91.9%(79/86)、73.3%(63/86),差异均具有统计学意义(P<0.05);Steinberg分期中早期检出率分别为53.5%(46/86)、41.9%(36/86),确诊率分别为90.7%(78/86)、70.9%(61/86),差异均具有统计学意义(P<0.05)。3种分期方法中早期检出率为依次为Ficat>ARCO>Steinberg,但差异不具有统计学意义(P>0.05);CT灌注成像检查出骨小梁结构模糊23例(26.7%),骨髓水肿21例(24.4%),线样征27例(31.4%),单一囊变35例(40.7%),均显著高于X线检出结果(P<0.05)。结论CT灌注成像对股骨头缺血坏死进行诊断,与X线检查相比,具有更高的确诊率和早期检出率,能准确地为后期治疗提供诊断依据。

Preliminary Application of Perfusion Imaging in Neoplasm in the Brain and Body with Multi-slice Helical CT

Objective： To evaluate the clinical value of perfusion imaging in neoplasm in the brain and body with Multi-slice helical CT. Methods： Twenty-eight patients with neoplasm were subjected to perfusion imaging with multi-slice helical CT, including 22 patients with brain neoplasm and 6 patients with body neoplasm. At first, CT routine scan was preformed to localize central slices of neoplasm. Then perfusion imaging of 4 and identical slices in central slices of neoplasm was performed by using CT cine scan. Scanning images were transferred into ADW3.1 work-station to create and analyze perfusion images and parameters. Results： Perfusion parameters of cerebral neoplasm had a remarkable increase. But, CBF value of different cerebral neoplasms had partial overlap; CBV value was increased slightly; MTT value had no apparently clinical value; PS value was increased significantly, pituitary neoplasm〉meningoma〉cerebral glioma≈cerebral metastasis. PS value could reveal the characters of cerebral neoplasm and had apparently clinical value. Perfusion parameters of body neoplasms have a remarkable increase too. Body tumors were liable to be interfered by breath movement. Perfusion parameters were helpful to differentiation diagnosis of neoplasm in the brain and body. PS images of neoplasm in the brain and body were helpful to defining tumor outline and finding small tumor. Conclusion： MSCT perfusion imaging provided a precise and relative simple method to quantitatively estimate blood perfusion status in tumors in the brain and body. The technique can be easily implemented on clinical scanners.

Clinical study of stomach neoplasm CT perfusion imaging

Objection:The purpose of this study is preliminarily to discuss stomach perfusion imaging technique with Multi-slice CT and its clinical application value in stomach neoplasm.Methods:Fifteen patients with known stomach neoplasm performed perfusion imaging with 4 or 16 slice CT.Performing perfusion imaging in central slice of neoplasm,using CT cine scan,slice thick 10 mm/2i;with high pressure syringe,injecting quickly from right elbow-front vein,dosage 45-50 mL,injec-tion rate 3.5-4.0 mL/s,scanning delay time 5 s,scanning total time 45 s.We performed perfusion CT post-processing using pancreatic mode of perfusion CT software.Blood flow(BF),blood volume(BV),mean transit time(MTT),and permeability surface(PS) of gastric wall and tumor were computed for every case.Results:BF,BV,MTT and PS of gastric tumor were 116.68 ± 90.09 mL/(min·100 g),9.57 ± 8.12 mL/100 g,10.07 ± 7.74 s,20.78 ± 19.68 mL/(min·100g),respectively.The P values for each CT perfusion parameters between gastric tumor and normal gastric wall were 0.001,0.021,0.155 and 0.031,respectively.Conclusion:Perfusion CT can provide hemodynamics of gastric tumors and play a key role in the diagnosis of gastric tumors.It's clinical application prospect will be fully broad.

Application of CT perfusion imaging in detection of tumor angiogenesis in osteosarcoma

Objective： The aim of the study was to explore the application of 64-slice spiral computed tomography perfusion imaging （CTPI） in evaluating angiogenesis in human osteosarcoma. Methods： Twenty-six patients （18 males and 8 females ranging from 9 to 56 years old, with an average of 19 years） with osteosarcoma underwent 64-slice spiral CTPI. We analyzed the correlations of CTPI parameters including blood flow （BF）, blood volume （BV）, time to peak （TTP）, and permeability surface （PS） with the expression of markers of angiogenesis. Statistical analysis was performed with paired-samples t test, and Pearson correlation analysis was employed to investigate the correlations of CTPI parameters with microvessel density （MVD）. Results： Mean BF, BV, TTP, and PS values of osteosarcoma group were （46.6 ± 25.1） mL/100 g/min, （61.8 ± 29.5） mL/100 g, （122.9 ± 26.2） seconds, and （44.5 ± 14.6） mL/100 g/min, respectively. Those in the normal muscle group were （5.2 ± 6.6） mL/100 g/min, （9.6 ± 7.3） mL/100 g, （115.5 ± 33.1） seconds and （17.0 ± 29.3） mL/100 g/min, respectively. Osteosarcoma group showed higher BF, BV and PS compared with the normal muscle group （P = 0.000, P = 0.000, and P = 0.000, respectively）. However, no significant difference was found in TTP between osteosarcoma tissue and normal adjacent muscle tissue （P = 0.273）. BF, BV, and PS were positively correlated with MVD （r = 0.83, P = 0.000; r = 0.87, P = 0.000; and r = 0.63, P = 0.001, respectively）. No correlation was found between TTP and MVD （r = –0.02, P = 0.93）. Conclusion： CTPI is useful for assessing tumor vascularity of osteosarcoma and CTPI parameters are positively correlated with MVD.