320排CT双入口灌注技术对小细胞肺癌疗效评估的价值  

Value of dual-input perfusion of 320 row CT on the efficacy evaluation of small cell lung cancer

作　　者：万广志 马春燕 管静芝[1] 解国清[1] 李仁德 周晶晶 刘斌[1] 董凯生 Wan Guangzhi;Ma Chunyan;Guan Jingzhi;Xie Guoqing;Li Rende;Zhou Jingjing;Liu Bin;Dong Kaisheng(Department of Oncology, the 8th Medical Center of Chinese PLA General Hospital, Beijing 100091, China;Department of Obstetrics and Gynecology, Chinese Medicine Hospital of Heze, Heze 274000, China)

机构地区：[1]解放军总医院第八医学中心肿瘤科,北京100091 [2]山东省菏泽市中医医院妇产科,274000

出　　处：《肿瘤研究与临床》2019年第3期162-166,共5页Cancer Research and Clinic

基　　金：吴阶平医学基金(320.6750.18008);北京医学奖励基金(YXJL-2017-0159-0055、YXJL-2018-0504-0049).

摘　　要：目的探讨采用320排CT双入口灌注技术对小细胞肺癌疗效评估的价值。方法收集2016年6月至2018年6月就诊于解放军总医院第八医学中心的经病理学确诊的小细胞肺癌患者18例,均接受顺铂联合依托泊苷方案化疗。所有患者均于化疗前、化疗2个周期后、4个周期后3个时间点行320排CT灌注扫描,获取肿块的大小、灌注伪彩图及支气管动脉血流量(BF)、肺动脉血流量(PF)和灌注指数(PI)。评估疗效及不良反应。组间计量资料比较采用单因素方差分析,相关分析采用Pearson检验。结果2例患者化疗2个周期后完全缓解(CR),2例患者化疗4个周期后CR,此4例CR的患者中有3例BF丰富;化疗4个周期后,7例患者部分缓解(PR),6例患者病情稳定(SD),1例患者疾病进展(PD)。320排CT双入口灌注技术检测显示,10例治疗前肿瘤面积<15cm^2,其余8例>15cm^2。治疗前肿瘤面积<15cm^2患者中,PI与治疗前肿瘤面积呈负相关(r=-0.694,P=0.026),治疗前肿瘤面积>15cm^2的患者中,PI与治疗前肿瘤面积无相关性(P>0.05)。1例患者出现Ⅳ级骨髓抑制,其余患者均未见明显不良反应。结论采用320排CT双入口灌注技术,在单纯影像学检查的基础上依据灌注参数可对小细胞肺癌疗效做出准确的定量判断,为小细胞肺癌的疗效评估提供了新的依据。Objective To discuss the value of dual-input perfusion of 320 row CT on the efficacy evaluation of small cell lung cancer (SCLC). Methods A total of 18 patients with SCLC confirmed by pathology who received cisplatin plus etoposide chemotherapy between June 2016 and June 2018 in the 8th Medical Center of Chinese PLA General Hospital were collected. All patients received 320 row CT perfusion scan at 3 time points before chemotherapy, after 2 cycles and 4 cycles of chemotherapy. Tumor size, perfusion pseudo color map and bronchial arterial blood flow (BF), pulmonary flow (PF) and perfusion index (PI) were obtained. The efficacy and adverse reactions were evaluated. The single factor analysis was used to make the group comparison. Pearson test was used to make correlation analysis. Results Two patients after 2 cycles of chemotherapy had complete remission (CR), another 2 patients after 4 cycles of chemotherapy had CR, and 3 patients of the above 4 cases with CR had abundant BF;after 4 cycles of chemotherapy, 7 cases had partial remission (PR), 6 cases had stable disease (SD), 1 patient had progression of disease (PD). Dual-input perfusion of 320 row CT showed that 10 cases had the tumor area < 15 cm^2 and 8 cased had the tumor area > 15 cm^2 before the treatment. There was a negative correlation between PI and the tumor area (r=-0.694, P = 0.026) on patients with the tumor area < 15 cm^2 before the treatment, and no correlation was found in patients with tumor area >15 cm^2 (P > 0.05). One case had Ⅳ degree of bone marrow suppression, and obvious adverse reactions were not seen in the rest of the patients. Conclusion Dual-input perfusion of 320 row CT based on the simple imaging can make an accurate quantitative judgement of the effect of SCLC according to perfusion parameter, which provides a new basis for curative effect evaluation on SCLC.

关 键 词：小细胞肺癌 肺灌注显像 双入口灌注CT 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]