多层螺旋CT灌注成像对脑肿瘤瘤周水肿的临床应用

目的探讨瘤周水肿的多层螺旋cT灌注成像（CTPI）在脑肿瘤诊断方面的应用价值。方法采用Sensation16层螺旋CT机对本院29例脑肿瘤患者（胶质瘤14例，转移瘤7例，脑膜瘤8例）行CTPI，分别测量不同瘤周水肿区以及对侧正常脑组织的脑血流量（CBF）、脑血容量（CBV）、肿瘤表面渗透性（PS）、对比剂峰值时间（timetopeak，TIP，并进行比较。结果转移瘤和脑膜瘤瘤周水肿的CBV、CBF显著低于对侧正常脑组织（P〈0．05），PS差异则无统计学意义（P〉0．05）。与对侧正常脑组织比较，胶质瘤瘤周水肿的CBV差异无统计学意义（P〉0．05），而PS明显升高（P〈0．05），CBF降低（P〈0．05）。胶质瘤、转移瘤及脑膜瘤3者瘤周水肿的TTP值均较对侧正常脑组织显著延长（P〈0．05）。结论脑肿瘤的CTPI检查能定量反映瘤周水肿区的血流动力学状况，对脑肿瘤的鉴别和预测预后有重要临床意义。

Clinical application of perfusion imaging in peritumoral edema of cerebral neoplasms with multislice spiral CT

Objective To evaluate the value of multi-slice CT(MSCT)perfusion imaging in the diagnosis of cerebral neoplasms by analyzing the parameters obtained from peritumoral brain edema(PTBE).Methods Twenty-nine patients with peritumoral brain edema,including pathologically confirmed gliomas 14 cases,metastasis 7,meningioma 8,were examined by MSCT perfusion imaging.Cerebral blood volume(CBV),cerebral blood flow(CBF),time to peak(TTP)and permeability surface(PS)values were calculated from PTBE and the contralateral normal brain tissue was analyzed.Results The CBV and CBF of PTBE were signifiacantly lower in patients with metastasis and meningioma than those of contralateral normal brain tissue(P<0.05),but the PS was not significantly different.In patients with gliomas,the PS of PTBE was signifiacantly higher than that of contralateral normal brain tissue(P<0.05),and the CBF of PTBE was lower(P<0.05),but the CBV was not significantly different.The TTP of PTBE in all the patients were significantly prolonged as compared to contralateral normal brain tissue(P<0.05).Conclusion MSCT perfusion imaging provides quantitative information of haemodynamic changes in PTBE,and may help make differential diagnosis and evaluate prognosis in cerebral tumors.