能谱CT在评价植入^(125)I放射粒子治疗肺癌的早期疗效中的应用  

Application of spectral CT in evaluating the early effect of CT-guided ^(125)I radioactive seed implantation for lung cancer

作　　者：张铭[1] 沈加林[1] 

机构地区：[1]上海交通大学医学院附属仁济医院肿瘤介入科,上海200127

出　　处：《临床肺科杂志》2017年第2期203-206,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的初步探讨能谱CT参数在植入^(125)I放射粒子治疗肺癌的早期疗效评估中的应用。方法收集经临床和病理证实的肺癌患者50例,其中腺癌35例,鳞癌15例。分别于CT引导下植入^(125)I放射粒子治疗前及治疗后早期(<1个月)进行能谱CT增强扫描,获得动脉期、静脉期图像,得到碘基物质图像、水基物质图像、70keV水平的单能量图像和能谱曲线斜率,并对治疗前后的数据进行对比分析。结果 50例患者病灶经植入^(125)I放射粒子治疗后的碘基值(iodine content,IC)、70keVCT值、能谱曲线斜率均较前明显减低,差异有统计学意义(P均<0.05),水(碘)基含量均低于治疗前,动脉期水基值治疗前后的差异无统计学意义(P>0.05),而静脉期水基值治疗前后的差异有统计学意义(P<0.05)。结论能谱CT可反映^(125)I放射粒子治疗前后病灶的血供特点及灌注程度变化,有助于^(125)I放射粒子治疗肺癌的早期疗效评估。Objective To explore the value of spectral CT in early efficacy evaluation of CT-guided 125I radioactive seed implantation for lung cancer. Methods The study selected 50 patients with lung cancer, including 35 cases of adenocarcinoma and 15 cases of squamous carcinoma. All the patients were given CT-guided 125I radioactive seed implantation before and early after treatment （ 〈 1 month）. By enhanced CT scan, their iodine-substance images, water-based images, 70keV energy CT value and energy spectrum curve slope at pulmonary artery phase and venous phase were acquired, and the differences of these parameters before and after treatment were statistically analyzed. Results The iodine （water） content at arterial phase and venous phase and energy spectrum curve slope of the lesions after 125I seed implantation treatment were lower than those before treatment （ all P 〈 0. 05 ）. The water （ iodine） content at arterial phase and venous phase was lower than that before treatment, but the difference at arterial phase were not statistically significant （ P 〉 0. 05 ）, and the difference at venous phase were statistically significant （P 〈 0. 05 ）. Conclusion Spectral CT can reflect the changes of blood supply and perfusion degree of lung cancer before and after 125I seed implantation treatment, which is helpful to evaluating the early efficacy of CT-guided 125I seed implantation for lung cancer.

关 键 词：肺癌 疗效评估 能谱CT 碘基值 

分 类 号：R734.2[医药卫生—肿瘤]