双源双能量CT在晚期胃癌患者化疗疗效评价中的应用价值研究  

Appraising Chemotherapy Effects of Late-stage Gastric Cancer by Dual-source Dual-energy Computed-tomography

作　　者：石磊[1] 张欢[1] 潘自来[1] 刘欢欢[1] 张素[2] 杜联军[1] 丁蓓[1] 宋琦[1] 凌华威[1] 刘博 陈克敏[1] 严福华[1] 

机构地区：[1]上海交通大学附属瑞金医院放射科 [2]上海交通大学生物医学工程学院 [3]西门子医疗系统集团

出　　处：《中国医学计算机成像杂志》2013年第1期28-32,共5页Chinese Computed Medical Imaging

基　　金：国家自然科学基金No.81272746;上海交通大学医工交叉基金No.YG2012MS48~~

摘　　要：目的:研究双源双能量CT碘值测量对于晚期胃癌患者化疗疗效评价的应用价值。方法:对13例胃镜病理确诊为胃癌,且最终诊断为不可切除的晚期胃癌患者(男性7例,女性6例,平均年龄62岁)进行研究。所有患者均行奥沙利铂联合法玛新+希罗达化疗(EOX)化疗方案,化疗前后均行双源双能量CT增强扫描,以前后两次扫描所获得病灶最长径缩小的百分比,分为疗效较好组和疗效价较差组。通过碘图测量病灶碘值,分析治疗前碘值差异及治疗前后碘值变化与肿瘤大小评价疗效的关系。结果:疗效较好组化疗前病灶碘值在动脉晚期明显高于疗效较差组(P=0.01)。疗效较好组病灶碘值减小率在动脉晚期及门脉期均大于疗效较差组的碘值减小率(P<0.01,P=0.02)。结论:双源双能量CT测量病灶碘值减少率可以帮助预测及评估晚期胃癌患者化疗疗效。Purpose： To study the iodine value of tumor by dual-source dual-energy computed-tomography （DSDECT） scan in appraising chemotherapy effects of late-stage gastric cancer. Methods： A total of 13 patients with pathologically proved gastric cancer by endoscopy were prospectively enrolled in our study, and all of the patients were certified as unresectable gastric cancer. There were 6 women and 7 men with a mean age of 62 years, and all of them received three cycles of epirubicin, oxaliplatinneo and xeloda chemotherapy. DEDSCT contrasted scan were performed before and after chemotherapy. The lesions were classified as having responded well or poorly according to the percentage of maximum diameter alterations obtained from the before and after scans. The iodine value of the lesions was measured using iodine map. The differences of the iodine value before chemotherapy and between the good- and poor- response groups were analyzed. Re- suits： The iodine values of the lesions before chemotherapy were significantly different between the good- and poor- response groups in the late arterial phase （P=0.01）. The entire reduction ratio of the iodine value in the good-response group was significantly higher than that in the poor-response group in the late arterial phase and the portal venous phase （P〈0.01, P=0.02）. Conclusion： The reduction ratio of the iodine value obtained from DSDECT measurement can be helpful in predicting and evaluating chemotherapy effects oflate-stage gastric cancer.

关 键 词：双源 双能量 体层摄影术 X线计算机 胃癌 化疗 

分 类 号：R735.2[医药卫生—肿瘤]