人脑胶质瘤256层CT灌注成像  

Perfusion 256-Slice CT Imaging of Human Gliomas

作　　者：陆娜[1] Haleena Ramsahye 冯晓源[2] 强金伟[1] 廖治河[1] 蒋玲[3] 

机构地区：[1]复旦大学附属金山医院放射科,上海201508 [2]复旦大学附属华山医院放射科,上海200040 [3]上海交通大学附属中国福利会国际和平妇幼保健院放射科,上海200030

出　　处：《中国临床医学》2013年第3期375-378,共4页Chinese Journal of Clinical Medicine

基　　金：国家自然科学基金资助项目(编号:30970805);上海市卫生局青年科研项目(编号:2011-187);高等学校博士学科点专项科研基金项目(编号:200802460039);上海市金山区卫生局科研课题青年项目(编号:JWKJ-KTYQ-201202);上海市金山区卫生系统优秀青年人才培养计划(编号:JWKJ-RCYQ-201202);金山医院优秀青年人才培养计划(编号:2012-3)

摘　　要：目的:探讨人脑胶质瘤256层CT灌注成像的可行性并研究胶质瘤的灌注特点。方法:2010年1月—2012年2月行脑256层CT灌注成像扫描受检者55例,其中健康者15例(对照组),胶质瘤患者40例[包括低级别胶质瘤15例(低级别胶质瘤组)、高级别胶质瘤25例(高级别胶质瘤组)]。采用MIStar后处理软件,在病灶最大层面选取感兴趣区(region of interest,ROI),获得ROI的脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)、平均通过时间(mean transittime,MTT)和表面通透性等灌注参数。应用方差分析(Analysis of Variance,ANOVA)检验比较对照组、低级别胶质瘤组和高级别胶质瘤组灌注参数的差异。结果:40例胶质瘤患者均经病理证实。高级别胶质瘤组患者的CBF、CBV和表面通透性分别为(51.41±11.60)mL/(100 g.min)、(6.26±1.67)mL/100 g和(5.71±2.22)mL/(min.100 g),均高于低级别胶质瘤组[(32.73±7.06)mL/(100 g.min)、(2.98±0.73)mL/100 g和(2.33±0.47)mL/(min.100 g)];低级别胶质瘤组的CBF、CBV和表面通透性均高于对照组[(21.06±2.06)mL/(100 g.min)、(1.76±0.17)mL/100 g和(0.90±0.07)mL/(min.100 g)],差异均有统计学意义(P均<0.01)。3组MTT比较,差异无统计学意义。表面通透性为2.88 mL/(min.100 g)时,敏感度为96%,特异度为93%;CBV为3.91 mL/100 g时,敏感度为92%,特异度为93%;CBF为38.90 mL/(100 g.min)时,敏感度为92%,特异度为86%。结论:256层CT灌注成像可在一定程度上反映人脑胶质瘤的肿瘤血流动力学情况。Objective：To evaluate the feasibility of using perfusion 256-slice CT imaging in the examination of human gliomas and to investigate the perfusion characteristics of gliomas.Methods：From Jan 2010 to Feb 2012,among 55 subjects who underwent perfusion 256-slice CT imaging,there were 40 patients with gliomas（25 patients with high grade gliomas,15 patients with low grade gliomas） and 15 healthy volunteers served as controls.The raw data including cerebral blood flow（CBF）,cerebral blood volume（CBV）,mean transit time（MTT） and permeability surface-area product of region of interest（ROI） were processed using CT perfusion software.The statistical analysis was performed to compare the difference among controls,low grade gliomas and high grade gliomas using ANOVA test.Results： A total of 40 patients with gliomas have been proved by the histopathological results.CBF,CBV and permeability surface-area product in high grade gliomas were（51.41±11.60）mL/（100 g·min）,（6.26±1.67）mL/100 g and（5.71±2.22）mL/（min·100 g）,respectively;in low grade gliomas they were（32.73±7.06）mL/（100 g·min）,（2.98±0.73）mL/100 g and（2.33±0.47）mL/（min·100 g）,respectively;and in controls they were（21.06±2.06）mL/（100 g·min）,（1.76±0.17）mL/100 g and（0.90±0.07）mL/（min·100 g） respectively.Significant differences of CBF,CBV and permeability surface-area product were observed among high grade gliomas,low grade gliomas and controls（P all0.01）.There were no difference in MTT among 3 groups.When cutoff value of permeability surface-area product was 2.88 mL/（min·100 g）,the sensitivity and specificity were 96 % and 93 %.When cutoff value of CBV was 3.91 mL/100 g,the sensitivity and specificity were 92 % and 93 %.When cutoff value of CBF was 38.90 mL/（100g·min）,the sensitivity and specificity were 92 % and 86 %.Conclusions： Perfusion 256-slice CT imaging can provide useful parameters for glioma hemodynamics.

关 键 词：胶质瘤 体层摄影术 X线计算机 灌注 

分 类 号：R445[医药卫生—影像医学与核医学]