不同分组肾透明细胞癌CT灌注成像的差异

目的 探讨不同分组肾透明细胞癌CT灌注成像的差异.资料与方法 经手术病理证实为肾透明细胞癌的患者40例,术前应用多层螺旋CT(MSCT),选择肿瘤最大层面进行灌注扫描.用去卷积法灌注软件获取肿瘤内多个不同密度感兴趣区(ROI)及双侧肾皮质的血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)及时间-密度曲线(TDC)图.40例肿瘤按是否可见新生血管、肾盂肾盏受累程度及是否有癌栓分组,统计分析比较不同分组肿瘤间的灌注差异.结果 可见新生血管的肿瘤表面通透性低于未见新生血管肿瘤(P＜0.05);肾盂肾盏受压肿瘤同侧肾脏皮质血流量(C-BF)高于肾盂肾盏无影响肿瘤(P＜0.01);有癌栓肿瘤双侧皮质及最高密度点BV均低于无癌栓肿瘤(P＜0.05).结论 CT灌注成像能从血流动力学和血管功能上为评价肾透明细胞癌进展和预后带来帮助,具有一定的临床应用价值.

The Difference of CT Perfusion Imaging of Clear Cell Renal Cell Carcinoma in Different Groups

Objective To discuss the difference of CT perfusion imaging of clear cell renal cell carcinoma in different groups.Materials and Methods CT perfusion scans were performed through the central slices of the tumor in 40 cases with pathologically confirmed clear cell renal cell carcinoma.The software of deconvolution calculated a series of perfusion parameters of regions of interest(ROIs)in tumor and cortexes of both kidney,including blood flow(BF),blood volume(BV),mean transit time(MTT),permeability surface(PS)and the time-density curve(TDC curve).The 40 cases with clear cell renal cell carcinoma were differentiated by neovascularization,affect on renal calices and cancer embolus,and the perfusion parameters were analyzed statistically.Results PS of tumor with visible neovascularization was lower than that of tumor without visible neovascularization(P<0.05);BF of tumor side renal cortex of tumor with pressed renal calices is higher than that of tumor without affect on renal calices(P<0.01);Blood volume of both renal cortex and MAX ROI(the area in tumor with maximal perfusion)of tumor with cancer embolus is lower than that of tumor without cancer embolus(P<0.05).Conclusion CT perfusion imaging is valuable for evaluation of prognosis of clear cell renal cell carcinoma.