多层螺旋CT灌注技术在胰腺肿瘤术前鉴别诊断中的临床应用

目的评价多层螺旋CT灌注技术各常见参数对胰腺肿块鉴别诊断的价值。方法选取行多层螺旋胰腺灌注检查的患者47例，其中15例为无胰腺疾病的正常患者，16例病理诊断为胰腺癌，16例病理或临床诊断为胰岛细胞瘤。分别采用最大斜率法及去卷积法测量得到正常胰腺、胰腺癌和胰岛细胞瘤的灌注参数值血流量、血容量、达峰时间、渗透性及平均通过时间。比较胰腺癌组与正常胰腺组及胰岛细胞瘤组各灌注参数值的差异，采用独立样本t检验进行统计学分析。结果最大斜率法示胰腺癌组的BF、BV均明显低于正常胰腺组，差异均有统计学意义（P〈0．05）；胰腺癌组的rrrP大于正常胰腺组，差异均有统计意义（P〈0．05）；PM在胰腺癌组和正常胰腺组间没有统计学差异（P〉0．05）。胰腺癌组的BF、BV明显小于胰岛细胞瘤组，差异非常显著；胰腺癌组的1rrP大于胰岛细胞瘤组，差异具有统计学意义（P〈0．05）；PM在胰腺癌组和胰岛细胞瘤组间无统计学差异。去卷积法：胰腺癌组的BF、BV均明显低于正常胰腺组，差异均有统计意义（P〈0．05）；胰腺癌组的TTP大于正常胰腺组，差异均有统计意义（P〈0．05）；MTT在两组样本间没有统计学差异（P〉0．05）。胰腺癌组的BF、BV明显小于胰岛细胞瘤组，差异非常显著；胰腺癌组的MTF、TTP大于胰岛细胞瘤组，差异具有统计学意义（P〈0．05）。结论两种CT灌注算法的部分参数均能够帮助对胰腺癌与正常胰腺、胰岛细胞瘤进行鉴别诊断。

Clinical application of perfusion imaging with multi-slice spiral CT in the preoperative differential diagnosis of tumor of pancreas

Objective To evaluate the use of perfusion imaging with 64-slice CT in the differential diagnosis of pancreatic masses.Method Totally 47 subjects including 15 normal patients,16 patients diagnosed pancreatic carcinoma pathologically or clinically,7 patients diagnosed pancreatic adenoma pathologically or clinically and 16 patients diagnosed islet cell tumor pathologically or clinically underwent contrast-enhanced abdominal scanning and pancreatic perfusion scanning. Images were then transferred to workstatio...