多层螺旋CT灌注成像在脑肿瘤的初步应用

目的初步评价多层螺旋CT脑肿瘤灌注成像方法以及其临床应用价值。方法28例已知全身肿瘤性病变患者在我院行MSCT灌注成像扫描。其中包括22例脑肿瘤和6例体部肿瘤患者。首先行CT平扫以确定肿瘤中心层面,然后采用CT电影扫描技术对肿瘤中心层面进行四层同层灌注扫描。扫描图像经ADW3。1工作站处理,计算并分析灌注图像和灌注参数。结果脑肿瘤的灌注参数有明显增高。但是,不同脑肿瘤的CBF值之间可有一定的交叉;CBV值有轻微增加;MTT值的临床价值不大,尚有待于进一步研究;PS值显著增加,垂体瘤>脑膜瘤>胶质瘤≈转移瘤。PS值可放大肿瘤的灌注特点并有临床意义显著。体部肿瘤的灌注参数也有明显增高。体部肿瘤容易受到呼吸运动的干扰。灌注参数有助于不同脑部和体部肿瘤的鉴别诊断。PS图像还有助于肿瘤瘤体真正范围的确定,以及发现小的可疑病灶。结论MSCT灌注成像提供了一种准确而相对简捷的定量评估全身肿瘤血流灌注状态的方法。这种技术很容易应用于临床。

Preliminary Application of Perfusion Imaging in Neoplasm in the Brain and Body with Multi-slice Helical CT

Objective: To evaluate the clinical value of perfusion imaging in neoplasm in the brain and bodywith Multi-slice helical CT. Methods: Twenty-eight patients with neoplasm were subjected to perfusionimaging with multi-slice helical CT, including 22 patients with brain neoplasm and 6 patients with bodyneoplasm. At first, CT routine scan was preformed to localize central slices of neoplasm. Then perfusionimaging of 4 and identical slices in central slices of neoplasm was performed by using CT cine scan.Scanning images were transferred into ADW3.1 work-station to create and analyze perfusion images andparameters. Results: Perfusion parameters of cerebral neoplasm had a remarkable increase. But, CBFvalue of different cerebral neoplasms had partial overlap; CBV value was increased slightly; MTT value hadno apparently clinical value; PS value was increased significantly, pituitary neoplasm>meningoma>cerebralgliomafscerebral metastasis. PS value could reveal the characters of cerebral neoplasm and had apparentlyclinical value. Perfusion parameters of body neoplasms have a remarkable increase too. Body tumors wereliable to be interfered by breath movement. Perfusion parameters were helpful to differentiation diagnosisof neoplasm in the brain and body. PS images of neoplasm in the brain and body were helpful to definingtumor outline and finding small tumor. Conclusion: MSCT perfusion imaging provided a precise andrelative simple method to quantitatively estimate blood perfusion status in tumors in the brain and body.The technique can be easily implemented on clinical scanners.