多层螺旋CT灌注扫描对鼻咽癌放射敏感性的预测价值  

The value of multislice CT perfusion scanning in the prediction of the radiotherapy sensitivity in nasopharyngeal carcinoma

作　　者：陆忠华[1] 黄云海[2] 张乐[2] 汤华[1] 戴科军 

机构地区：[1]苏州大学附属常州肿瘤医院放疗科,江苏常州213002 [2]苏州大学附属常州肿瘤医院影像科,江苏常州213002

出　　处：《蚌埠医学院学报》2014年第2期178-181,共4页Journal of Bengbu Medical College

基　　金：江苏省常州市卫生局重大资助项目(ZD200802)

摘　　要：目的：探讨多层螺旋CT灌注成像扫描对鼻咽癌放射敏感性的预测价值。方法：对经病理证实的52例鼻咽癌治疗前行螺旋CT动态扫描，通过时间-密度曲线计算鼻咽癌和未受侵犯的翼外肌的灌注数据。患者均接受放疗，外照射至放疗剂量DT50Gy时行鼻咽部CT复查，分别测量治疗前和外照射放疗剂量DT50Gy时肿瘤最大截面积，观察血流量（BF）、血容量（BV）、平均通过时间（MTT）和表面通透性（PS）等功能参数与肿瘤消退率（Rs0-50）的关系。结果：52例鼻咽癌的BF、BV、MTF和PS分别为（385．79±39．08）ml·min^-1·100g^-1，（14．49±16．29）ml／100g，（3．34±1．5）S和（65．13±10．02）ml·min^-1·100g^-1。相关分析结果显示，BF、BV、MTT、PS和肿瘤面积与Rs0-50均无相关关系（P〉0．05）。将Rs0-50≤0．75定为放疗低敏感组，〉0．75为高敏感组，放疗高敏感组的BV和BF均显著高于放疗低敏感组（P〈0．01），而Ps明显低于放疗高敏感组（P〈0．01）。结论：鼻咽肿瘤组织的CT灌注参数BV、BF能预测其对放疗的敏感性。Objective ：To explore the value of multislice CT perfusion scanning in the prediction of the radiotherapy sensitivity in nasopharyngeal carcinoma. Methods ：The spiral CT dynamic scanning in 52 patients with nasopharyngeal carcinoma were implemented before treatment. The perfusion data of nasopharyngeal carcinoma and inviolate wing muscle were calculated through the time-density curve. All patients were treated with radiation therapy, the CT scanning of the nasopharynx were reexamined when the external exposure arrived at DTS0 Gy. The relationship between maximum cross-sectional area of tumor, blood flow（ BF）, blood volume （BV）, mean transit time（MTT） ,permeability surface（PS） and tumor regression function parameters and tumor regression rate（ Rs0-50 ） were measured before treatment and at the DT50 Gy of external exposure. Results ： The BF, BV, MTY and PS of 52 patients with nasopharyngeal tumor were（385.79 ±39.08） ml · min^-1 · 100 g^-1,（14.49±16.29） ml/100 g,（3.34 ±1.5） s and（65.13 ±10.02） ml · min^-1 · 100 g^-1 ,respectively. The correlation analysis showed that there were not relevant relationships between the BF, BV, MIT,PS and tumor area and Rs0-50 （P 〉 0.05 ）. Rs0-50 less than or equal to 0.75 and more than 0.75 were set as low sensitive group and high sensitive group, respectively. The BV and BF in high sensitive group were significantly higher than those in low sensitive group （P 〈 0.01 ）, while PS was just the opposite （P 〈 0.01 ）. Conclusions：The BV and BF of CT perfusion parameters in nasopharyngeal tumor can predict their sensitivity to radiotherapy

关 键 词：鼻咽肿瘤 灌注成像 放射敏感性 体层摄影术 X线计算机 

分 类 号：R739.63[医药卫生—肿瘤]