胃癌计算机断层成像灌注扫描初探  

Detection of computer tomography perfusion in gastric cancer

作　　者：张欢[1] 潘自来[1] 杜联军[1] 宋琦[1] 丁蓓[1] 凌华威[1] 陈克敏[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,200025

出　　处：《中华消化杂志》2006年第7期453-455,共3页Chinese Journal of Digestion

基　　金：上海自然科学基金(01ZB14044)

摘　　要：目的探讨计算机断层成像灌注扫描与血管密度计数(microvessel density,MVD)、病理分级以及TNM分期间的关系。方法31例经活检证实的胃癌患者行多层螺旋(MS)CT灌注扫描并计算灌注各参数[肿瘤血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透面积(PS)]。术后采用抗CD34单克隆抗体进行免疫组化试验检测MVD。结果灌注扫描研究中血管PS与TNM、病理分级以及淋巴转移间差异有统计学意义(P＜0．05),BF、BV、MTT与TNM、病理分级、浸润深度、淋巴转移、远处转移以及MVD间差异均无统计学意义(P＜0．05)。结论灌注扫描作为新的无创伤性评价肿瘤血管生成方法具有较高的临床应用价值．其中PS与多个胃癌预后指标相关,有可能成为胃癌预后判断的相关指标。Objective To evaluate the relationship between CT perfusion imaging and clinicopathological features in gastric adenocarcinoma. Methods CT perfusion was performed in 31 cases of gastric cancer diagnosed by endoscopy and biopsy one week prior to operation. After an oral intake of 1000-1200 ml of water and an injection of hypotonic agent, perfusion scan was adopted in sixteen multislice spiral CT （MSCT） with 60 s of cine duration. Data were analyzed by a commercial software to calculate tumor blood flow （BF）, blood volume （BV）, mean pass time （MTT） and permeability surface （PS）. Microvessl density （MVD） was evaluated by using immunohistochemical staining of surgical specimens with anti-CD34. All these findings were prospectively analyzed and correlated with the chnicopathological findings （histological grading, presence of lymph node metastasis, serous involvement, TNM staging and MVD）. Results There was significant difference of PS value not only between patients with and without lymphatic involvement （P 〈 0. 05）, but also in different histological grade （P 〈 0.05） and TNM staging （P 〈 0.05）. However BF, BV, MTT and MVD of gastric cancer revealed no significant correlation with the clinicopathological findings above （P 〉 0. 05）. Conclusion The analysis of CT perfusion imaging in gastric cancer, especially PS value, might be helpful in predicting the prognosis.

关 键 词：胃肿瘤 微血管密度 计算机断层成像灌注扫描 预后 

分 类 号：R735.2[医药卫生—肿瘤]