胃肿瘤CT灌注成像临床价值的初步探讨

目的]探讨胃肿瘤CT灌注成像的可行性,评价其在胃肿瘤性病变诊疗中的初步价值。方法]对13例胃肿瘤患者进行了4排和16排CT灌注成像扫描。采用CT电影扫描技术对肿瘤中心层面进行灌注扫描,层厚10 mm/2 i;使用高压注射器经右肘前静脉快速团注造影剂,剂量45～50 mL,注射速度3.5～4.0 mL/s,扫描延迟时间5 s,扫描总时间45 s。利用胰腺模式进行CT灌注数据的处理,计算血流量（BF）、血容量（BV）、平均通过时间（MTT）以及表面渗透性（PS）。结果]正常胃壁的BF、BV、MTT、PS分别为（357.24±212.44）mL/（min·100 g）、（16.53±9.78）mL/100 g、（4.29±3.12）s、（36.40±39.54 ）mL/（min·100 g）;胃肿瘤的则为（62.18±38.1）mL/（min·10 0 g）、（5.21±4.58）mL/100 g、（1 1.79±8.18）s、（13.09±12.62）mL/（min·100 g）,P值 分别为0.0017、0.014、0.04和0.036。结论]CT灌注成像可提供胃肿瘤的血流动力学信息,在 胃肿瘤的诊断中有一定价值,其临床应用前景广阔。

Preliminary clinical evaluation of CT perfusion imaging of stomach neoplasm

Objective] The purpose of this study is preliminarily to discuss perfusion imaging technique with Multi-slice CT and its clinical application value of diagnosis in stomach neoplasm.Methods] Thirteen patients with known stomach neoplasm performed perfusion imaging with 4 or 16-slice CT.Performing perfusion imaging in central slice of neoplasm,using CT cine scan,slice thick 10 mm/2i;with high pressure syringe,injecting quickly from right elbow-front vein,dosage 45～50 mL,injection rate（3.5～4.0） mL/s,scanning delay time 5 s,scanning total time 45 s.We performed perfusion CT post-processing using pancreatic mode of Perfusion CT software.Blood flow（BF）,blood volume（BV）,mean transit time（MTT）,and permeability surface（PS） of gastric wall were computed for every case.Results] BF,BV,MTT and PS of normal gastric wall were（357.24±212.44） mL/（min·100 g）,（16.53±9.78） mL/100 g,（4.29±3.12） s,（36.40±39.54） mL/（min·100 g）;for gastric tumors were（62.18±38.1） mL/（min·100 g）,（5.21±4.58） mL/100 g,（11.79±8.18） s,（13.09±12.62） mL/（min·100 g） respectively.The P values for perfusion CT parameters between gastric tumors and normal gastric wall were 0.0017,0.014,0.04 and 0.036,respectively.Conclusion] Perfusion CT can provide hemodynamics of gastric tumors and play a key role in the diagnosis of gastric tumors.It＇s clinical application prospect will be fully broad.