CT灌注成像在预测宫颈鳞癌同步放化疗短期效果中的价值

目的确定灌注参数预测宫颈鳞状细胞癌同步放化疗短期效果的价值。方法将93例晚于ⅡB期的宫颈鳞癌病人纳入本研究。所有的病人行CT灌注扫描,随后接受同样的同步放化疗。根据短期治疗效果将病人分为敏感组和不敏感组。对两组灌注参数的基准值进行比较。对可能影响治疗     

肝硬化和肝癌病人与肿瘤相关性新生血管形成的定量评价:动态CT灌注成像的作用

目的确定CT灌注扫描(CT-p)在定量评价肝细胞癌(HCC)病人与肿瘤相关性新生血管形成过程方面的价值。材料与方法52个经活检证实HCC病灶,在注射50mL对比剂(350mgI/mL)后行动态CT扫描。使用有彩色刻度的动脉和门静脉定量灌注图的专用灌注软件。计算以下与血液     

肾细胞癌MSCT灌注成像研究

目的：测定正常肾脏皮质的各灌注参数,探讨肾细胞癌的多层螺旋CT灌注表现,分析不同病理亚型肾细胞癌的灌注是否有差异。方法：73例肾细胞癌,其中透明细胞癌65例、乳头状癌3例、嫌色细胞癌5例。术前行多层螺旋CT灌注扫描,分别测量肾癌病灶、患侧肾脏及对侧肾脏正常皮质的血容量（BV）、血流量（BF）、平均通过时间（MTT）和表面通透性（PS）,并进行统计学分析。结果：正常肾脏皮质BV、BF、MTT及PS分别为（23．53±5．71）ml／100g、（454．32±110．90）ml／（min·100g）、（3．62±1．38）S、（63．95±18．85）ml／（min·100g）。肾癌病灶BV、BF、MTT及PS分别为（17．17±8．34）ml／100g,（261．96±175．86）ml／（min·100g）、（7．08±3．42）s、（25．07±13．20）ml／（min·100g）。其中透明细胞癌BV、BF、MTT及PS分别为（17．97±8．30）ml／100g,（279．61±177．02）ml／（min·100g）、（6．85±3．39）S、（25．78±12．94）ml／（min·100g）;乳头状癌BV、BF、MTT及PS分别为（4．82±2．93）ml／100g,（52．00±51．77）ml／（min·100g）、（11．74±3．63）s、（11．90±5．12）ml／（min·100g）;嫌色细胞癌BV、BF、MTT及PS分别为（14．22±3．21）ml／100g,（158．49±49．79）ml／（min·100g）、（7．26±1．77）s、（23．69±17．41）ml／（min·100g）,肾细胞癌BV、BF、PS较正常肾脏皮质减低（P〈0．01）,MTT较正常肾皮质增加（P〈0．01）。透明细胞癌BV、BF均较乳头状癌高（P〈0．05）,透明细胞癌MTT较乳头状癌低（P〈0．05）,透明细胞癌BV、BF均较嫌色细胞癌高（P〈0．05）,透明细胞癌BV、BF均较非透明细胞癌高（P〈0．05）,余各病理亚型间各参数无差异。结论：多层螺旋CT灌注扫描可以直观地反映肾细胞癌与正常肾脏组织的灌注差异,且各病理亚型的血流灌注有明显的差异。     

CT灌注成像在肾细胞癌诊断中的应用

目的 探讨CT灌注成像在肾细胞癌诊断及鉴别诊断的价值.方法 本研究共包括39例肾细胞癌、12例良性肿瘤患者,均有完整的临床和病理资料.所有病例行肾脏常规CT平扫后,选定灌注扫描层面,以4.0 ml/s的速度团注对比剂50 ml,注射对比剂后延迟6 s,采用Siemens Bodyperfusion体部灌注扫描序列,对选定相邻2层部位进行连续动态增强扫描.利用SIEMENS Perfusion CT/VA11A软件对灌注扫描图像进行后处理,生成表示腹部器官血流的伪彩灌注图.将各图转入ROI Evaluation子菜单,利用感兴趣区法(region of interest)测量血流量(blood flow)、血流容积(blood volume)、无血管血流量(flow without vessels)、组织强化峰值(peak enhancement)、灌注起始时间(time to start)和峰值时间(time to peak).结果 肾细胞癌的血流值、血流容积、无血管血流量和组织强化峰值均高于/大于良性肾肿瘤,而灌注起始时间小于良性肾肿瘤;采用Siemens Perfusion CT/VA11A软件得到的肾细胞癌、肾良性肿瘤的灌注值分别为(1.52±0.68)、(0.65±0.32)ml·min-1·ml-1.结论 CT灌注成像可较好地检测肾脏肿瘤的血流动力学情况,有助于术前判断肾脏肿瘤性质.     

食管鳞状细胞癌侵犯外膜的MSCT特征及病理学基础对照分析

目的 探讨食管鳞状细胞癌侵犯食管外膜的多层螺旋CT(multi-slice spiral CT,MSCT)特征及其病理学基础.方法 收集手术病理证实已侵犯食管全层的食管鳞状细胞癌23例,所有病例均行16层螺旋CT胸部增强扫描,根据轴位及多平面重组图像(MPR)判断病灶是否侵犯外膜及外膜受侵的方位特征,并与术后病理对照分析.结果 食管鳞状细胞癌23例,MSCT显示肿瘤侵犯食管外膜21例,其诊断准确率为91%.肿瘤侵犯食管外膜仅位于病灶最大层面2例(9%),位于病灶最大层面与非最大层面19例(83%).肿瘤侵犯位置位于病灶最大厚度2例(9%),位于病灶非最大厚度19例(83%).肿瘤侵犯位置位于最大层面最大厚度处2例(9%),位于最大层面非最大厚度处19例(83%).食管鳞状细胞癌侵犯外膜层面与最大厚度层面无相关性(P＞0.05),受侵犯处管壁厚度与最大层面最大厚度无相关性(P＞0.05).结论 食管鳞状细胞癌侵犯外膜的MSCT具有一定特征性.     

^18FDG—PET在诊断头颈部鳞状细胞癌复发中的价值

目的了解18FDG-PET在诊断头颈部鳞状细胞癌复发中的价值,确定标准吸收值(SUV)来鉴别放疗后的炎症与肿瘤复发.材料和方法头颈部鳞状细胞癌患者43例,在放疗后至少4个月(平均11个月)进行18FDG-PET检查.计算感兴趣区的SUV值.肿瘤复发诊断依赖组织病理学检查或6个月以上的临床随访.结果43例患者中,FDG-PET阳性23例,其中3例为假阳性;20例为阴性,其中假阴性2例.FDG-PET的诊断准确性是88%(38/43),而CT/MRI的诊断准确性则为66%(25/38).肿瘤复发病灶和炎症病灶的SUV有部分重叠,无统计学上差异(p=0.31).结论18FDG-PET检测头颈部鳞状细胞癌复发中肉眼分析更有价值;18FDG-PET较CT/MRI更为准确.     

CT灌注成像评价肝细胞癌TACE前后血供的初步经验

目的:探讨经导管动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)前后血流灌注变化。材料和方法:对21例HCC患者TACE治疗前、后1个月行CT灌注成像扫描,测量肿瘤组织治疗前后肝动脉灌注值(HAP)、门静脉灌注值(HPP)及肝动脉灌注指数(HPI)。结果:治疗前7例肿瘤组织肝动脉灌注图呈均匀高灌注,14例呈不均匀高灌注,液化坏死区无血流灌注。门静脉灌注图,20例呈低灌注,1例无血流灌注。TACE后肿瘤组织HAP及HPI显著减少,HPP无明显变化。5例病灶碘油完全充填,16例病灶部分区域碘油充填,碘油区无血流灌注,肿瘤残留区仍有血流灌注。结论:CT灌注成像为评价TACE疗效提供了一个新方法。     

双源CT灌注成像在肾细胞癌及肾盂癌诊断中的应用研究

目的分析双源CT(DSCT)肾细胞癌、肾盂癌灌注参数的特点,探讨灌注成像对肾细胞癌及肾盂癌诊断的应用价值。方法回顾性分析经手术病理证实的34例肾细胞癌、15例肾盂癌,行西门子Somatom Sensation 64螺旋CT灌注扫描,应用西门子工作站分别测量肿瘤及对照组正常肾皮质的灌注参数:血流(BF)、血容量(BV)、开始时间(TTS)、达峰时间(TTP)、Patlak血管通透性(PS)、Patlak血容量(PBV)。结果①肾细胞癌BF、BV、PS、PBV低于对侧正常肾皮质(对照组),而TTP则高于对照组肾皮质,二者之间差异有统计学意义(P<0.05);肾细胞癌TTS高于对照组肾皮质,二者之间差异无统计学意义(P>0.05);②肾盂癌BF、BV、PS、PBV低于对侧正常肾皮质(对照组),二者之间差异有统计学意义(P<0.05);肾盂癌TTS高于对照组肾皮质,而TTP则低于对照组肾皮质,二者之间差异无统计学意义(P>0.05);③肾细胞癌BF、BV、PBV高于肾盂癌,二者之间差异有统计学意义(P<0.05);肾细胞癌TTS低于肾盂癌,而TTP、PS则高于肾盂癌,二者之间差异无统计学意义(P>0.05)。结论肾细胞癌、肾盂癌及正常肾皮质DSCT灌注参数不同。DSCT灌注成像在肾脏DSCT灌注成像在肾细胞癌及肾盂癌诊断和鉴别诊断方面有一定的应用价值。     

原发性支气管肺癌钙化的CT表现特征

目的探讨原发性支气管肺癌钙化的CT表现特征及其鉴别诊断。材料和方法经病理证实的内有肉眼可见之钙化的原发性支气管肺癌16例,回顾性分析CT像所见钙化的形态、大小和分布特征及与原发肿瘤大小和病理类型间的关系,并与病理对照研究,用非配对t检验行统计学分析。结果病灶直径2.0～13cm,平均5.6cm。直径5cm以下者3例。周边型钙化8例,中心型者7例,另1例既有中心又有周边型钙化。钙化数目1例4枚,1例2枚,其余均为1枚。病理包括腺癌7例,鳞状细胞癌5例,小细胞癌2例,低度恶性肿瘤1例,未能分型1例。结论原发性肺癌的钙化常见于较大的肿块内,常表现为小结节或斑点状,与钙化的分布无关。     

多层螺旋CT的MPR、CTVE重建用于软腭肿瘤的诊断价值

目的探讨螺旋CT多平面重建（MPR）和CT仿真内镜（CTVE）用于软腭肿瘤的诊断价值。资料与方法本组15例中涎腺混合瘤8例，海绵状血管瘤2例，鳞状细胞癌3例，黏液表皮样囊肿2例。将螺旋CT容积扫描获得的图像数据在GE4．0AW工作站上进行MPR和CTVE重建。结果15例软腭肿瘤的矢状面和冠状面MPR表现软腭不同程度肿大，口咽腔和鼻咽腔均不同程度狭窄。涎腺混合瘤、黏液表皮样囊肿密度略低，周围境界清楚；鳞状细胞癌周围境界不清，表面不规则；海绵状血管瘤软腭弥漫性增厚。CTVE显示软腭口咽腔侧和鼻咽腔侧不同程度局部隆起。鳞状细胞癌表面凹凸不平。结论CT的MPR和CTVE能很好地显示软腭和肿瘤的全貌。MPR显示肿瘤的密度和向周围浸润程度，CTVE能很好地显示口咽腔和鼻咽腔内表面立体图像，类似纤维内镜所见。     

Myocardial perfusion and perfusion reserve in endurance-trained men

PURPOSE: This study was undertaken to determine whether endurance training is associated with changes in myocardial perfusion in humans. METHODS: Myocardial perfusion was measured in eleven trained and nine sedentary men at rest and during adenosine-stimulated hyperemia using positron emission tomography (PET). Left ventricular (LV) dimensions and mass were measured using echocardiography. Myocardial work per gram of tissue was calculated as (cardiac output. mean arterial blood pressure)/LV mass. RESULTS: LV mass was significantly higher and myocardial work per gram of tissue lower in the trained than in the untrained subjects. Basal (0.78 +/- 0.10 and 0.76 +/- 0.15 mL. min-1. g-1, P = NS) and adenosine-stimulated perfusion (3.46 +/- 0.91 and 3.14 +/- 0.70 mL. min-1. g-1, P = NS) were similar between trained and untrained men, respectively. Consequently, myocardial perfusion reserve was similar in both groups (4.4 +/- 1.2 and 4.1 +/- 0.7, P = NS). In addition, coronary resistance at baseline (115 +/- 17 vs 119 +/- 22, mm Hg. mL. min-1. g-1, P = NS) and during adenosine infusion (28 +/- 8 vs 30 +/- 8, mm Hg. mL. min-1. g-1, P = NS) were similar in both groups. Resting myocardial work correlated with resting myocardial perfusion in both groups, but the relationship between perfusion and work was different between the groups so that perfusion for a given myocardial work was significantly higher in trained subjects (0.56 +/- 0.04 and 0.34 +/- 0.05 mL. (mm Hg. L)-1, P < 0.001). CONCLUSIONS: These findings suggest that endurance trained subjects do not have different resting or adenosine-stimulated myocardial perfusion. However, the relationship between myocardial perfusion and work appears altered in the athletes.     

Hepatic perfusion during hepatic artery infusion chemotherapy: evaluation with perfusion CT and perfusion scintigraphy

The standard method for the evaluation of hepatic perfusion during hepatic artery infusion (HAI) chemotherapy is planar hepatic artery perfusion scintigraphy (HAPS). Planar HAPS was performed with 2 mCi of [99mTc] macroaggregated albumin infused at 1 ml/min and compared with single photon emission CT (SPECT) HAPS and with a new study, CT performed during the slow injection of contrast material through the HAI catheter (HAI-CT). Thirteen patients underwent 16 HAI-CT studies, 14 planar HAPS studies, and 9 SPECT HAPS studies. In 13 of 14 studies (93%) HAI-CT and planar HAPS were in complete agreement as to the perfusion pattern of intrahepatic metastases and normal liver. In nine studies where all modalities were performed, the findings identified by HAI-CT and planar HAPS agreed in all cases, whereas the results of two SPECT scans disagreed with the other studies. With respect to perfusion of individual metastases, 14 of 14 HAI-CT studies, 12 of 13 planar HAPS studies, and 9 of 9 SPECT HAPS studies correctly demonstrated the perfusion status of individual lesions as indicated by the pattern of changes in tumor size determined on CT obtained before and after the perfusion studies. Hepatic artery infusion CT was superior for delineation of individual metastases, particularly small lesions, and for the evaluation of nonperfused portions of the liver. Planar HAPS detected extrahepatic perfusion in four patients, and this was not detected by HAI-CT. We conclude that HAI-CT and scintigraphy are complementary techniques. Hepatic artery infusion CT has advantages for the evaluation of intrahepatic perfusion, and planar HAPS is superior to HAI-CT for the detection of extrahepatic perfusion.     

Automatic and visual reproducibility of perfusion and function measures for myocardial perfusion SPECT

Background  

We define the repeatability coefficients (RC) of key quantitative and visual perfusion and function parameters that can be derived by the QGS/QPS automated software and by expert visual observer from gated myocardial perfusion SPECT (MPS) scans.     

Challenges for measurement of myocardial perfusion and perfusion reserve by SPECT imaging

Conclusions  The present study by Storto et al¹ provides additional evidence that quantitative estimates of myocardial perfusion and perfusion reserve can be derived from SPECT myocardial perfusion images by use of equipment, tracers, and techniques that are available in most nuclear cardiology laboratories. Additional clinical studies are needed to optimize the methods used to derive the quantitative estimates of perfusion and perfusion reserve from the SPECT imaging studies and, ultimately, to determine the applicability of these measurements to the daily practice of nuclear cardiology.     

State-of-the-art-myocardial perfusion stress testing: Static CT perfusion

Large multicenter studies and meta-analysis have documented the diagnostic accuracy and the prognostic implications of stress echocardiography, cardiac magnetic resonance and, mainly, nuclear stress tests. However, none of them provides a comprehensive anatomical and functional evaluation within the same study as stress CT perfusion. Myocardial CT perfusion is the only non-invasive modality that allows to quantifying coronary stenosis and determining its functional relevance, constituting a potential “one-stop-shop” method for the diagnosis and global management of patients with known or suspected coronary artery disease. In comparison with the dynamic modality, that requires increased radiation, precise acquisition protocols and dedicated post-processing softwares, static CT perfusion was associated with less radiation exposure, non-inferior diagnostic accuracy, easier interpretation of images and is nowadays more widely available.     

Diffusion and perfusion of the kidney

MRI of the kidney currently makes the transition from depiction of morphology to assessment of function. Functional renal imaging methods provide information on diffusion and perfusion on a microstructural level. This review article presents the current status of functional renal imaging with focus on DWI (diffusion-weighted imaging) and DCE-MRI (dynamic contrast-enhanced MRI), as well as BOLD (blood-oxygenation level dependent) MRI, DTI (diffusion tensor imaging) and arterial spin labeling (ASL). Technical background of these techniques is explained and clinical assessment of renal function, parenchymal disease, transplant function and solid masses is discussed.     

Diffusion and perfusion of the breast

This article is a review of the current published clinical applications of DWI and perfusion of breast MR explaining possibilities and limits of both techniques.DWI in a fast time acquisition and without contrast medium gives information as regards cellularity of breast lesions. The technique can be used for distinguishing between benign and malignant breast lesions and monitoring therapies in locally advanced breast cancer.Perfusion can give additional information as regards vascularization of breast lesions, useful in the characterization of breast lesions doubt at DCE-MRI and also in monitoring chemotherapic effect.