一站式CT灌注成像联合增强扫描用于胰腺神经内分泌肿瘤

目的探讨一站式CT灌注成像联合增强扫描对于胰腺神经内分泌肿瘤(pNEN)的应用价值。方法回顾30例接受一站式CT灌注成像联合增强扫描并经组织病理证实的pNEN患者,分析pNEN影像学特点,比较其灌注伪彩图灌注参数血容量(BV)、血流量(BF)、平均通过时间(MTT)、毛细血管表面通透性(PS)]及时间-密度曲线(TDC),分析不同分级pNEN灌注参数差异和辐射剂量。结果灌注伪彩图显示pNEN病灶较正常实质呈明显高灌注状态,其BV、BF分别为(22.80±6.42)ml/100 g、(237.38±134.86)ml/(min·100 g),均高于正常实质(P均<0.05);MTT、PS分别为(7.03±3.48)s、(3.25±1.99)ml/(min·100 g),均低于正常实质(P均<0.05)。pNEN病灶早期显影时间为19.42~24.14 s,其TDC表现为速升后速降至平台期。依据不同pNEN级别,将pNEN病灶分为A组(G1级)和B组(G2/G3级),A组病灶PS为(4.48±2.21)ml/(min·100 g-),高于B组(2.23±1.34)ml/(min·100 g,P<0.05),组间BV、BF、MTT差别均无统计学意义(P均>0.05),PS与pNEN级别呈负相关(r=-0.52,P<0.01)。扫描全过程有效辐射剂量为(19.88±3.03)mSv。结论CT灌注联合增强扫描可依据病灶形态学表现及灌注参数诊断pNEN,并有助于常规增强CT扫描选择对可疑pNEN病灶的最佳扫描时间,且辐射剂量较低,并可根据PS预测肿瘤分级,对临床有一定指导意义。

One-stop pancreas perfusion CT combined with enhancement in evaluation on pancreatic neuroendocrine neoplasms

Objective To explore the value of one-stop pancreas perfusion CT combined with enhancement in evaluation on pancreatic neuroendocrine neoplasms (pNEN). Methods A total of 30 patients with histopathologically proved pNEN who underwent one-stop pancreas perfusion CT combined with enhancement scan were collected. Imaging features of pNEN were analyzed, the perfusion parameters (blood volumeBV], blood flow, mean transit timeMTT] and capillary surface permeabilityPS]) and tissue time density curve (TDC) were observed, the perfusion parameters were compared between different grades of tumors, and the efficacy of radiation dose was analyzed. Results Pseudo-color images showed that compared with surrounding pancreatic tissue, significantly higher-perfusion was observed in pNEN tissue, with BV of (22.80±6.42)ml/100 g, BF of (237.38±134.86)ml/(min·100 g),significantly higher than those of surrounding pancreatic tissue (both P<0.05). MTT of pNEN tissue was (7.03±3.48)s, PS was(3.25±1.99)ml/(min·100 g), both lower than surrounding pancreatic tissue (both P<0.05). The developing time of pNEN lesion was approximately 19.42-24.14 s. TDC showed a rapid ascending trend and then rapid decreasing to the plateau in pNEN tissue, whereas a slowly increasing to the peak value and then a slight decrease to the plateau in the normal tissue. According to histopathological grades, pNEN were divided into groups A(G1) and B(G2/G3).PS values of group A (4.48±2.21]ml/min·100 g^-]) and B (2.23±1.34]ml/min·100 g]) were significantly different (P<0.05), while BV, BF and MTT values were not (all P>0.05). There was negative correlation between PS and tumor grade (r=-0.52, P<0.01). The total X-ray dose of whole scan was (19.88±3.03)mSv. Conclusion One-stop pancreas perfusion CT combined with enhancement scan can diagnose pNEN according to morphological features and perfusion parameters with small radiation dose, and PS parameters may distinguish pNEN grading preoperation. One-stop pancreas perfusion CT combined with enhancement scan is helpful to choice of optimal scanning time of suspicious pNEN lesions during conventional enhanced CT.