鼻咽癌多层螺旋CT灌注成像的初步研究

目的探讨CT灌注成像技术对鼻咽癌(NPC)放疗后局部复发和放疗后纤维化的鉴别诊断价值。方法对正常人对照组20例、鼻咽癌治疗前组15例、鼻咽癌放疗后局部复发组14例和鼻咽癌放疗后纤维化组22例(4组共71例)研究对象进行鼻咽部CT灌注成像扫描,分析各组病灶区局部的时间密度曲线(TDC)和灌注参数特点及其差异。结果NPC治疗前组和放疗后复发组之TDC形态与其余2组明显不同;各组血流量(BF)均数两两比较差异均有显著性(Ρ<0.01);血容量(BV)和表面通透性(PS)值均数两两比较,除纤维化组与对照组之间差异无统计学意义外,其余各组间差异均有显著性(Ρ<0.05);平均通过时间(MTT)值均数两两比较,仅对照组与其余各组间差异有显著性(Ρ<0.01)。结论NPC放疗前、后局部不同病理结构的CT灌注参数和TDC具有不同特点。CT灌注成像技术对NPC放疗后局部复发和放疗后纤维化的鉴别诊断具有重要价值。

The Primary Study of Multi-slice Helical CT Perfusion in Nasopharyngeal Carcinoma

Objective To study the value of CT perfusion in differential diagnosis of local recur and local radiofibrosis of nasopharyngeal carcinoma(NPC) at pre-and post-radiotherapy.Methods Dynamic CT scan was performed in 71 objectives: 14 in local recur group,22 in radiofibrosis group,15 in pre-radiotherapy NPC group and 20 in control group,the time-density curve(TDC) and the data of perfusion parameters were recorded and analyzed statistically.Results The TDC feature between local recur group,pre-radiotherapy NPC group and radiofibrosis group,control group had difference.The average of blood flow(BF) had significant differences by two by two comparison in four groups(P<0.01).Except for the control group and radiofibrosis group,the average of blood volume(BV)and permeability surface(PS) had statistical differences(P<0.05).While in mean transit time(MTT),the significant difference between the control group and other three groups was only found(P<0.01).Conclusion The TDC and perfusion parameters of local different structures of pre-radiotherapy and post-radiotherapy NPC are of different characteristics,which are helpful for the differential diagnosis of post-radiotherapy local recurrence and local radiofibrosis.