多层螺旋CT在非小细胞肺癌微波消融手术及预后的质量评估与预测研究  

Application value of MSCT in MWA of NSCLC and prediction of prognostic quality

作　　者：王进 李涛[2] 李剑[1] WANG Jin;LI Tao;LI Jian(不详;Medical Imaging Department,The Fifth People's Hospital of Jinan,Jinan 250022,China)

机构地区：[1]济南市第五人民医院医学影像科,山东济南250022 [2]山东中医药大学第二附属医院放射科,山东济南250001

出　　处：《中国医学装备》2022年第7期49-53,共5页China Medical Equipment

基　　金：山东省医药卫生科技发展计划(2019WSA18081)“多层螺旋CT在NSCLC微波消融手术及预后质量预测中的应用价值”。

摘　　要：目的:探讨多层螺旋CT(MSCT)在非小细胞肺癌(NSCLC)微波消融(MWA)术中应用及预后预测的价值。方法:选取医院收治的经CT引导MWA术治疗的早期(Ⅰ~Ⅱ期)NSCLC患者56例,依据临床疗效不同分为缓解组(31例)和未缓解组(25例)。两组患者均在MWA术前后行MSCT灌注成像扫描,测定对比剂平均通过时间(MTT)、强化峰值(PEI)、表面通透性(PS)、血流量(BF)及血容量(BV)等指标的差异。对所有患者随访6~30个月,记录患者的生存率及生存时间。采用多元Logistic回归方程分析MSCT指标与患者病死率的关系。绘制Kaplan-Meier生存曲线分析MSCT灌注成像参数与患者预后情况的相关性。结果:治疗后两组患者MTT及BV参数值比较差异无统计学意义;未缓解组PS明显高于缓解组,差异有统计学意义(t=5.244,P<0.05),未缓解组PEI及BF值则明显低于缓解组,差异具有统计学意义(t=3.535,t=7.178;P<0.05)。56例患者中随访期存活43例,死亡13例。Logistic回归分析显示PEI及PS均是影响NSCLC患者MWA手术预后的独立影响因素(OR=0.023,OR=0.451;P<0.05);经Kaplan-Meier分析,PEI是OS的保护性因素(x^(2)=2.95,P<0.05),PS为OS和PFS的危险因素(x^(2)=3.14,x^(2)=3.17;P<0.05)。结论:MSCT灌注成像不仅能够评估NSCLC患者MWA手术治疗效果,还能够对患者预后进行评估,指导医师调整后续治疗方案。Objective:To explore the application of multi-slice spiral computed tomography(MSCT)in microwave ablation(MWA)for non-small cell lung carcinoma(NSCLC)and the value of that in prognostic prediction.Methods:A total of 56 patients with early stage(stageⅠ-Ⅱ)NSCLC who underwent CT-guided MWA treatment were selected,and they were divided into remission group and non-remission group according to the difference of clinical efficacy.Both groups of patients underwent multi-slice spiral CT(MSCT)perfusion imaging scans before and after MWA,and the mean transit time(MTT),peak enhancement image(PEI),permeability surface(PS),blood flow(BF)and blood volume(BV)of the contrast medium were determined.All patients were followed up for 6-30 months,and the survival rates and survival times of them were recorded.The multivariate Logistic regression equation was used to analyze the relationship between MSCT indicators and mortality of patient.The Kaplan-Meier survival curve was drawn to analyze the correlation between MSCT perfusion imaging parameters and the prognosis of patients.Results:In 56 patients,31 cases were remission and 25 cases were not remission.The differences of MTT and BV parameter values between two groups were not statistically significant.PS in non-remission group was significantly higher than that in remission group,the difference of that between two groups was statistically significant(t=5.244,P<0.05).PEI and BF in nonremission group were significantly lower than those in remission group(t=3.535,t=7.178,P<0.05).During the followup period,43 cases survived and 13 cases died.The results of Logistic regression analysis showed that PEI and PS were independent influence factors that affected the prognosis of NSCLC patients who underwent MWA surgery(OR=0.023,OR=0.451,P<0.05).The results of Kaplan-Meier analysis showed that PEI was a protective factor for OS(x^(2)=2.95,P<0.05),and PS was a risk factor of OS and progression-free survival(PFS)(x^(2)=3.14,x^(2)=3.17,P<0.05).Conclusion:MSCT perfusion imaging can not only a

关 键 词：非小细胞肺癌(NSCLC) 多层螺旋CT(MSCT) 经CT引导微波消融(MWA)术 疗效 预后 质量评估 

分 类 号：R734.2[医药卫生—肿瘤]