多层螺旋CT灌注成像在胰腺癌诊断中的应用价值

目的探讨多层螺旋CT(MSCT)灌注成像对胰腺癌的诊断及鉴别诊断价值。方法收集93例患者,按纳入标准分为正常对照组(48例)、胰腺癌组(31例)和急性胰腺炎组(14例),分别行胰腺MSCT灌注成像,随后将灌注原始数据传输至图像后处理工作站,设腹主动脉为输入动脉,门静脉或脾静脉为输出静脉,自动生成时间密度曲线(TDC)及灌注伪彩图。多点选取胰腺组织感兴趣区(ROI),需避开肉眼可见血管及胰腺边缘,ROI大小约20³0 mm2,分别测量3次,取其平均值,读出各ROI血流量(BF)、血容量(BV)、表面通透性(PS)和平均通过时间(MTT),分别计算三组BF、BV、PS、MTT和PS/BF。结果正常对照组BF、BV、PS、MTT、PS/BF分别为(120.196±27.686)ml·(100 g)-1·min-1、(25.324±5.012)ml/100 g、(18.314±22.227)ml·(100 g)-1·min-1、(13.655±2.780)s、0.150±0.770;胰腺癌组为(52.674±19.823)ml·(100 g)-1·min-1、(10.369±5.439)ml/100 g、(42.612±17.040)ml·(100 g)-1·min-1、(13.559±5.514)s、0.844±0.312;急性胰腺炎组为(89.689±26.788)ml·(100 g)-1·min-1、(18.221±7.600)ml/100 g、(41.342±21.581)ml·(100 g)-1·min-1、(15.018±6.600)s、0.498±0.287。胰腺癌BF、BV、PS/BF与正常胰腺和急性胰腺炎均有统计学差异(P<0.01);胰腺癌PS与正常胰腺有统计学差异(P<0.05),与急性胰腺炎组无统计学差异(P>0.05);三组间MTT无统计学差异(P>0.05)。结论 MSCT灌注成像对胰腺癌的诊断有重要参考价值,灌注参数BF、PS/BF对胰腺癌的诊断及鉴别诊断价值最大。

Multislice computed tomography perfusion in the diagnosis and differentiation of pancreatic carcinoma

Objective To investigate the value of MSCT perfusion diagnosis and differential diagnosis of pancreatic carcinoma. Methods 93 patients were divided into the normal control group （48 cases）, the pancreatic carcinoma group （31 cases） and the acute pancreatitis group （14 cases） according to the inclusion criteria. CT perfusion imaging of pancreas was done to each group. All perfusion data were transmitted to post-process workstation, at which the blood flow （BF）, blood volume （BV）, permeability surface （PS）, mean transit time （MTT） were measured by using pancreas perfusion software and calculate PS/BF in each group. All the data were recorded and statistically analyzed. Results The BF, BV, PS, MTT and PS/BF of the normal control group were （120.196±27.686）ml · （100 g）^-1 · min^-1, （25.324± 5.012）ml/100 g, （18.314±22.227）ml ·（100 g）^-1·min^-1, （13.655±2.780）s, 0.150±0.770, respectively. The BF, BV, PS, MTT and PS/BF of the pancreatic carcinoma group were （52.674±19.823）ml · （100 g）^-1· min^-1, （10.369±5.439）ml/100 g, （42.612±17.040）mi · （100 g）^-1·min^-1, （13.559±5.514）s, 0.844±0.312, respectively. The BF, BV, PS, MTr and PS/BF of the acute pancreatitis group were （89.689±26.788）ml · （100 g）^-1·min^-1, （18.221±7.600）ml/100 g, （41.342±21.581）ml · （100 g）^-1· min^-1, （15.018±6.600）s, 0.498i-0.287, respectively. Pancreatic carcinoma BF, BV, PS/BF with normal pancreas and acute panereatitis were statistically significant （P〈0.01）. Pancreatic carcinoma and normal pancreatic PS was statistically significant （P〈0.05）. And acute pancreatitis had no statistically significant （P〉0.05）. And there was no significant difference among MTT of three groups （P〉0.05）. Conclusion MSCT perfusion imaging plays an important role in diagnosis of pancreatic carcinoma and BF, PS/BF diagnosis and differential diagnosis of pancreatic carcinoma maximum.