CT灌注成像对脑膜瘤血流灌注的定量研究  

The preliminary research on the quantitative perfusion measurement of meningioma by CT perfusion imaging

作　　者：施裕新[1] 徐剑峰[1] 池鸣鸣[2] 

机构地区：[1]南通大学附属医院影像科,226001 [2]南通大学附属医院病理科,226001

出　　处：《中华放射学杂志》2004年第12期1269-1272,共4页Chinese Journal of Radiology

摘　　要：目的　探讨CT灌注成像对脑膜瘤定量诊断的价值。方法　应用SomatomPlus 4螺旋CT扫描机 ,对 13例手术病理证实的脑膜瘤患者 (其中脑膜瘤复发 2例 )进行CT灌注成像扫描。经灌注软件处理 ,使用 2 5 6彩色直观地显示脑组织中血流灌注图 ,并计算出局部脑血流量 (rCBF)、局部脑血容量 (rCBV)、对比剂平均通过时间 (MTT) ,并与对侧脑组织灌注参数和肿瘤病理类型进行统计分析比较。结果　脑膜瘤的rCBV、rCBF值明显高于对侧脑组织 [rCBV分别为 (16 12 5± 12 135 )ml/ 10 0g与 (2 15 8± 1 345 )ml/ 10 0g ;rCBF分别为 (89 6 2 7± 6 3 193)ml-1·10 0g-1·min-1与 (2 5 5 99± 9 2 6 6 )ml-1·10 0g-1·min-1,P值均 <0 0 0 2 ]。脑膜瘤的MTT值也明显高于对侧脑组织 [分别为 (9 2 0 3±4 4 34)s与 (3 85 7± 2 2 90 )s,P值均 <0 0 0 1]。 7例不典型脑膜瘤的rCBV、rCBF和MTT值明显高于 4例典型脑膜瘤 [rCBV值分别为 (2 0 94 8± 9 4 2 4 )ml/ 10 0g与 (4 0 15± 2 4 5 4 )ml/ 10 0g ,P <0 0 1;rCBF值分别为 (115 76 6± 6 8 0 92 )ml-1·10 0g-1·min-1与 (32 113± 4 90 4 )ml-1·10 0g-1·min-1,P <0 0 5 ;MTT值分别为 (10 35 2± 3 74 4 )s与 (4 6 85± 0 912 )s,P <0 0 1]。Objective To assess the contribution of CT perfusion in the quantitative diagnosis of meningiomas Methods The CT perfusion imaging was performed in 13 patients (including 2 recurrent meningiomas) by using Somatom Plus 4 helical CT The color map of relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), and mean transit time (MTT) was obtained by perfusion software, and rCBF, rCBV, and MTT were calculated in different areas Then the perfusion parameters and its mean ratios between tumor and contralateral normal brain tissue (CNBT) in each group of different pathologic types of meningiomas were compared using an unpaired or a paired Student t test Results The rCBV, rCBF, and MTT of meningiomas were significantly higher than those of CNBT [rCBV:(16 125±12 135) ml/100 g vs (2 158±1 345) ml/100 g, P <0 002; rCBF: (89 627±63 193) ml -1 ·100 g -1 ·min -1 vs(25 599±9 266 ) ml -1 ·100 g -1 ·min -1 , P <0 002; MTT (9 203±4 434) s vs(3 857±2 290) s, P <0 001] The rCBV, rCBF, and MTT of atypical meningiomas ( n =7) were significantly higher than those of typical meningiomas ( n =4) [rCBV: (20 948±9 424) ml/100 g vs (4 015±2 454) ml/100 g, P <0 01; rCBF: (115 766±68 092) ml -1 ·100 g -1 ·min -1 vs (32 113±4 904) ml -1 ·100 g -1 ·min -1 , P <0 05; MTT: (10 352±3 744) s vs(4 685±0 912 ) s, P <0 01] The rCBV and rCBF of 2 cases with recurrent anaplastic meningiomas were not significantly different from those of atypical meningiomas( P >0 05) The characteristic time density curve (TDC) with high peaks was seen in 5 cases The rCBV and rCBF of 4 cases with peritumor brain edema were significantly lower than those of CNBT Conclusion CT perfusion imaging can not only provide quantitative information of meningiomas blood flow and show characteristic dynamic TDC, but also is useful in assessing pathology of tumor and demonstrating lower perfusion in peritumor brain edema

关 键 词：不典型脑膜瘤 CT灌注成像 脑组织 血流灌注 MTT 瘤周水肿 复发 显示 软件处理 动态曲线 

分 类 号：R739.45[医药卫生—肿瘤] R743[医药卫生—临床医学]