多层螺旋CT灌注成像诊断脑肿瘤

目的探讨多层螺旋CT(MSCT)灌注成像在脑肿瘤诊断中的临床应用价值.方法 34例脑肿瘤行MSCT灌注成像扫描,其中脑胶质瘤10例,脑转移瘤9例,脑膜瘤7例,垂体瘤5例,脑胶质瘤复发3例.以3.5 ml/s速率静脉团注非离子对比剂50 ml,采用CT电影扫描技术对肿瘤中心层面进行四层同层灌注扫描,层厚10 mm/2i,扫描延迟时间5 s,数据采集45 s.应用Perfusion 软件进行灌注成像分析.结果脑肿瘤的血流量(CBF)值均显著增加,胶质瘤≈脑膜瘤＞转移瘤＞垂体瘤;脑血容量(CBV)值稍有增加,胶质瘤≈脑膜瘤＞转移瘤(垂体瘤无增加);平均通过时间(MTT)在转移瘤有明显延长;脑表面通透性(PS)值均显著增加,垂体瘤＞脑膜瘤＞胶质瘤≈转移瘤.复发胶质瘤的CBF值达110 ml/(100 g*min); PS图有助于肿瘤范围的准确界定和发现小病灶.结论 MSCT灌注成像在显示脑肿瘤血流灌注的特点、在脑肿瘤的鉴别诊断、肿瘤范围的界定以及在肿瘤术后复发诊断中均具有一定的临床应用价值.

Multi-slice CT perfusion imaging in diagnosis of cerebral neoplasms

Objective To assess the clinical application value of perfusion imaging with multi-slice helical CT (MSCT) in the diagnosis of cerebral neoplasms. Methods Thirty-four patients with brain neoplasms, including 10 cases with cerebral gliomas, 9 with brain metastases, 7 with meningiomas, 5 with pituitary neoplasms and 3 with recurrent neoplasms, underwent perfusion imaging by MSCT. The CT perfusion images were analyzed using perfusion software (GE). Results The mean CBF value and CBV value increased in cerebral neoplasms than in normal brain tissue. MTT value increased apparently in metastasis, while PS value increased apparently in all brain neoplasms. CBF value increased 2.5 times in recurrent neoplasms, reached 110 ml/(100 g·min). PS image was helpful to define the tumoral outline and find small tumor. Conclusion MSCT perfusion imaging plays an important role in revealing the brain neoplasms blood perfusion, in differential diagnosis of brain neoplasms, and in defining the tumoral margin and finding the recurrent tumors.