宽体探测器CT灌注成像评估胃癌分化程度研究  

Research on the application of CT perfusion imaging of wide detector in assessing differentiated degree of gastric carcinoma

作　　者：刘晓冬[1] 刘爱连[1] 刘静红[1] 刘义军[1] 李烨[1] 赵莹[1] 徐明哲[1] 陶奉明 王楠[1] 郭丹[1] LIU Xiao-dong;LIU Ai-lian;LIU Jing-hong(Department of Radiology,The First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院放射科,辽宁大连116011

出　　处：《中国医学装备》2020年第8期21-24,共4页China Medical Equipment

摘　　要：目的:探究宽体探测器(Revolution CT)灌注成像评估胃癌分化程度的诊断价值。方法:选取行腹部灌注扫描且经病理证实的54例胃癌患者,根据胃癌恶性分化程度分为高分化组、中分化组和低分化组,每组18例。注射85 ml碘海醇(350 mg I/ml)后6 s依照体质量指数(BMI)行RevolutionCT个体化间隔灌注扫描,使用体部灌注模型获得血容量(BV)、血流量(BF)、平均通过时间(MTT)、达峰时间(TP)、通透性(PS)、正增强积分(PEI)、最大上升斜率(MSI)、对比剂到达延迟时间(IRF)和到达脉冲剩余函数峰值通过时间(Tmax)灌注图像,使用方差分析及LSD检验比较各参数值的差异,统计辐射剂量。结果:两位医师观察数据一致性良好,组内相关系数(ICC)均>0.75,不同分化程度的BF及PS值差异有统计学意义(F=5.652,F=4.459;P<0.05),且随分化程度减低,BF及PS值逐渐升高。高分化组BV、MTT及Tmax值均低于中分化组;TP、PEI、MSI和IRF灌注参数组间比较均无统计学差异。3组平均辐射剂量为12.15 mSv。结论:胃灌注参数值BV、BF、MTT、PS和Tmax在一定程度可反映胃癌病理分化程度,具有潜在临床应用价值。Objective: To explore the diagnostic value of perfusion imaging of wide detector computed tomography(CT) in assessing differentiated degree of gastric carcinoma. Methods: 54 patients with gastric cancer who underwent abdominal perfusion scanning and were confirmed by pathology were selected and were divided into three groups(high differentiated group, moderately differentiated group and poorly differentiated group) according to the differentiated degree, with 18 cases in each group. All of patients underwent individual intermittent perfusion scanning of Revolution CT according to body mass index(BMI) at 6 th s after 85 mL iohexol(350 mg I/mL) was injected. Blood volume(BV), blood flow(BF), mean transit time(MTT), time to peak(TP), permeability surface(PS), positive enhancement integral(PEI), mean slope of interest(MSI), IRF To and perfusion images of Tmax were obtained by body perfusion module. The differences of various parameters were compared by analysis of variance and LSD test, and the radiation dose was calculated by statistic method. Results: The consistency of observed data of two physicians was favorable, and interclass correlation coefficients(ICC) of them were larger than 0.75, and the differences of BF and PS value of various differentiated degree were significant(F=5.652, F=5.459, P<0.05), and BF and PS values gradually increased with the decrease of differentiation degree. And the BV, MTT and Tmax value of high differentiated group were lower than those of moderately differentiated group. And the differences of TP, PEI, MSI and IRF perfusion parameters among different groups were no significant. The average radiation dose of three groups was 12.15 mSv. Conclusion: BV, BF, MTT, PS and Tmax of gastric perfusion parameters may reflect the pathologically differentiated degree of gastric carcinoma at a certain extent, and it has potentially clinical application value.

关 键 词：X射线计算机断层扫描(CT) 胃癌 分化程度 灌注成像 

分 类 号：R816.5[医药卫生—放射医学]