胃癌多层螺旋CT灌注成像及灌注参数与肿瘤因子的相关性研究  

Application of MSCT perfusion scanning and the correlation between CT perfusion parameters and tumor factors in gastric tumors

作　　者：黄刚[1] 王莉莉[1] 徐香玖[1] 毛泽庆[1] 赵雪梅[1] 

机构地区：[1]甘肃省人民医院放射科,甘肃兰州730000

出　　处：《中国临床医学影像杂志》2013年第10期695-697,705,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨多层螺旋CT灌注成像(Multi-slice CT perfusion imaging,MSCTPI)参数对胃癌的诊断价值及与肿瘤标志物之间的关系。方法:测得所有病例胃癌组与正常组的灌注参数:血流量(Blood flow,BF)、血容量(Blood volume,BV)、平均通过时间(Mean transit time,MTT)、表面通透性(Permeabbility surface,PS),两组比较采用t检验;采用Pearson相关分析法分析各灌注参数值与肿瘤标志物的关系;利用ROC曲线(Receiver operating characteristic curves,ROC)评判BV、BF、MTT、PS对胃癌的诊断效度。结果:胃癌组PS值明显高于对照组,差异有统计学意义(P<0.05),BF在两组间的差异有统计学意义(P<0.05),而BV、MTT在两组间的差异无统计学意义。Pearson相关分析法得出PS与AFP、CEA、CA199、CA72-4之间有相关性,r值分别0.58,0.40,0.38,0.77,BV、BF、MTT与CEA、AFP、CA199、CA72-4之间无明显相关性。应用ROC曲线分析BV、BF、MTT、PS对胃癌的诊断鉴别能力,其曲线下面积分别为0.62,0.64,0.50,0.83。当以PS>18.85 mL/(min·100 g)作为强烈提示胃癌组织的可能性时,其敏感度和特异度分别为0.88和0.67。结论:MSCT灌注成像可提供胃肿瘤的血流动力学信息,PS评价胃癌的效度最大,PS=18.85 mL/(min·100 g)可作为判断正常胃壁与胃癌的阈值。部分灌注参数与肿瘤标志物间有相关性。Objective： To explore the value of perfusion CT in the diagnosis of gastric tumors, and assess the relationship between perfusion imaging parameters and tumor factors of gastric cancer. Methods： All eases were divided into stomach can-cer group and normal group. The data of CTPI （BF, BV, MTT, PS） in gastric cancer and normal gastric wall were compared the study index was analysed by independent-samples t test. Pearson correlation were used to analyse the relationship between gastric cancer and tumor factors. Judge diagnostic validity of perfusion parameters on gastric cancer with ROC curve. Results： The level of PS in patient with gastric cancer was significantly higher than that of normal patients. The difference was statisti-cally significantly（P〈0.01）. The difference of BF between the two groups was statistically significant（P〈0.05）. The level of BV, MTT showed no significant difference between stomach cancer and normal group （P〉0.05）. Pearson correlation analysis showed PS had significant correlation with AFP, CEA, CA199, CA72-4（r=0.58, 0.40, 0.38, 0.77, respectively）. But BV, BF, MTT had no correlation with CEA, AFP, CA199, CA72-4. ROC curve were applied to BV, BF, MTT and PS in gastric cancer, the area under the curve were 0.62, 0.64, 0.50, 0.83 respectively. With an area under the ROC curve of PS=18.85 mL/（min. 100 g） as the diagnostic critical point. The sensitivity and specificity were 0.88 and 0.67 respectively. Conclusion： MSCTPI can provide hemodynamics of gastric tumors, thus playing a role in the diagnosis of gastric tumors, PS has the most important diagnostic significance. Some perfusion parameters had significant correlation with tumor marks.

关 键 词：胃肿瘤 体层摄影术 螺旋计算机 

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