多层螺旋CT结合病理对胃癌微血管密度的研究  

The Study on Microvessel Density of Gastric Cancer with Multi-slice Spiral CT and Pathology

作　　者：马凯[1] 王昌华[1] 梁玉青[1] 

机构地区：[1]山东省滕州市中心人民医院内镜中心,山东滕州277500

出　　处：《实用放射学杂志》2008年第4期499-501,508,共4页Journal of Practical Radiology

摘　　要：目的探讨胃肿瘤的微血管密度及其与CT征象的关系。方法64例胃癌病人行常规CT强化(剂量100ml欧乃派克,速度3.0ml/s),取45s时胃肿瘤图像,手术后将肿瘤标本连同部分正常胃组织(30min内)在CT室从其供血动脉实施不同压力注入造影剂(泛影葡胺,剂量10ml/100g),然后行多层螺旋CT扫描(延迟10s扫描1次,20s1次),后处理建立起肿瘤血管网,观察肿块的密度,与术前强化CT对照。肿瘤标本进行病理检查,并通过免疫组化计算肿瘤微血管密度,分析肿瘤的血液动力学特点。结果肿瘤内血管分布:(除坏死区外)肿瘤内最高密度(D)随肿瘤级别及分期的增加而增加,且肿瘤越靠周边密度越高。注药后标本的供血血管显影数量远高于术前常规强化时肿瘤供血血管的显影数量,但它们的D/d(肿瘤内最高密度/正常胃黏膜密度)比值基本一致。结论对于胃癌,常规增强CT的D/d比值在一定程度上反映肿瘤内部的微血管密度及肿瘤的血液动力学特点。Objective To investigate the microvessel density of stomach tumor and the relationship between the microvessel density and CT findings. Methods Conventional contrast - enhanced CT scans were performed in 64 patients with stomach tumor（OMNIPAQUE 100 ml, 3.0 mL/s） ,the images at 45 s were gained. After operation, the specimens with partial normal stomach tissue were dealed with injecting the contrast medium through its feeding arteries（10 mL/100 g , within 30 min） , then , the specimens underwent CT scanl delayed time 10 s and 20 s） ,the nets of blood vessel of the masses were reconstructed by post - processed. The density of masses was evaluated in comparison with the enhanced effect of masses before operation. The pathological examinations of specimens were done and the microvessel density of tumors were measured through immunohistochemical technique. The hemodynamic characteristics of tumors were analysed. Results In tumors ,the highest density（D） increased with the tumor rankl beside dead band）. The visive vessels of specimen were more than that on con- ventional contrast -enhanced CT, but the D/d （the highest density in the masses/the density in normal stomach tissue） was basically consistent. Conclusion For gastric carcinoma,the D/d ratio can reflect the microvessel density of the tumors on certainly and the hemodynamic characteristics of tumors.

关 键 词：胃 胃癌 血流动力学 微血管密度 体层摄影术 X线计算机 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]