结直肠癌螺旋CT灌注成像的初步研究  

The Preliminary Study of Spiral CT Perfusion in Colorectal Carcinoma

作　　者：孙灿辉[1] 孟悛非[1] 李子平[1] 彭李青 陈应明[1] 许达生[1] 严朝贵[1] 徐巧兰[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080 [2]深圳市龙岗区坑梓人民医院,518122

出　　处：《临床放射学杂志》2005年第6期506-510,共5页Journal of Clinical Radiology

基　　金：广东省社会发展领域科技计划项目(编号:200413960)

摘　　要：目的探讨螺旋CT(SCT)灌注成像方法在结、直肠癌中的初步临床应用。资料与方法经手术和病理证实的结直肠癌患者37例,术前先行结、直肠肿块范围的平扫,选定靶平面后再行同层动态增强扫描。绘制靶平面中肿瘤组织和靶血管感兴趣区(ROI)的时间密度曲线(TDC)。根据TDC计算癌灶的强化峰值(PH)、对比剂峰值时间(PT)、强化比值(CER)、对比剂平均通过时间(MTT)、癌灶的灌注量(PF)。采用Dukes分期法,将SCT灌注参数与临床病理因素(Dukes分期、浆膜浸润及淋巴结转移)进行比较。结果结、直肠癌癌灶PH值为(29.04±11.93)HU,PT值为(27.26±4.11)s,MTT值为(32.01±4.81)s,CER值为(10.29±3.06)%,PF值为(39.74±10.82)ml·min-1·100g-1。各灌注参数在Dukes分期、浆膜浸润、淋巴结转移中比较差异无显著性意义(P>0.05),PF随着Dukes分期的期别升高有下降趋势。结论SCT灌注成像可反映结、直肠癌的血流灌注状况,有其潜在的临床应用价值。Objective To evaluate the application of spiral CT perfusion in colorectal carcinoma (CRC).Materials and Methods 37 patients with histologically proven CRC were underwent with water enema spiral CT scan. The extent of the primary tumor was searched on unenhanced spiral CT images before operation to define the region of interest. Time-density curves (TDC) were created from the region of interest (ROI) with CT perfusion functional software. The parameters were measured including: peak height (PH), peak time (PT), mean transit time (MTT), contrast enhancement ratio (CER) and perfusion (PF). The correlation between the parameters and clinic, pathological factors (Dukes' stages, depth of invasion and lymph node metastasis) was studied. Results PH of CRC were (29.04±11.93) HU; PT were (27.26±4.11) s; MTT were (32.01±4.81) s ; CER were (10.29±3.06)%; PF were (39.74±10.82) ml·min -1·100g -1. The parameters were not associated with invasive depth, metastases, disease stage, as stage increased, PF of Dukes decreased.Conclusion Spiral CT perfusion imaging may reflect blood flow perfusion of CRC, and it has potential value of clinical application.

关 键 词：螺旋CT灌注成像 结直肠癌 步研究 Dukes分期法 淋巴结转移 动态增强扫描 平均通过时间 临床病理因素 临床应用价值 浆膜浸润 直肠癌患者 成像方法 病理证实 直肠肿块 感兴趣区 肿瘤组织 峰值时间 下降趋势 血流灌注 对比剂 

分 类 号：R735.3[医药卫生—肿瘤]