CT灌注扫描在脑肿瘤的临床应用

目的:研究颅内良恶性肿瘤多层螺旋CT各灌注参数的改变和肿瘤良恶性和脑内外肿瘤的鉴别诊断。方法:41例患者行脑血流的CT灌注扫描,其中脑内肿瘤26例(胶质瘤6例、脑脓肿2例、脑转移瘤17例、淋巴瘤1例),脑外肿瘤15例(颅骨转移瘤2例、垂体瘤7例、脑膜瘤2例、肉芽肿3例、蛛网膜囊肿1例)。应用去卷积算法模式计算相应病变区域的血流量(BF)、血容量(BV)、平均通过时间(MTT)、毛细血管通透性(PS)。根据不同肿瘤的相关参数图来评价良恶性肿瘤血流动力学状态。结果:41例脑肿瘤患者中,脑外肿瘤的CBF、CBV和PS明显高于脑内肿瘤,脑内肿瘤的恶性程度越高其CBF和PS越高,而MTT值与良性肿瘤组织无显著差异。结论:灌注参数CBF、CBV和PS可有效的评价脑肿瘤的血流状态,在脑部良恶性病变及脑内外肿瘤的鉴别诊断上有重要的临床应用价值。

Clinical application in cerebral neoplasm with CT perfusion scanning

Objective:To study MSCT perfusion imaging of benign or malignancy tumor of brain and differential diagnosis.Methods:Dynamic CT with single-location sequences CT scan of the brain were obtained in 41 individuals who include 26 patients with intra-cerebral mass(6 cases with cerebral glioma,2 cases with cerebral abscess,17 cases with brain metastases,1 case with cerebral lymphoma) and 15 patients with extra-cerebral tumor(2 cases with metastases of bone,7 cases with pituitary neoplasms,2 cases with meningioma,3 cases with granuloma of bone,1 case arachnoid cyst).Cerebral perfusion parameters include cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT) and permeability surface(PS).Results:Compared with 41 cases with cerebral tumor,CBF,CBV and PS increase slightly in extra-cerebral tumor more than intra-cerebral tumor,as well as increase slightly in malignant more than benign of intracerebral tumor,and MTT has not apparently clinical value.Conclusion:Cerebral perfusion parameters(CBF,CBV and PS) measured with CT were significantly altered in cerebral tumor,there have importanct appliance value in differentiate diagnosis of benign or malignant tumor.