肝外胆管癌双源CT灌注扫描临床应用价值初探

目的运用双源CT灌注成像方法,观察肝外胆管癌血流动力学变化,分析各灌注参数值、彩色灌注图及时间-密度曲线的形态,探讨双源CT灌注扫描对肝外胆管癌诊断及其分型的应用价值。方法选择临床怀疑为肝外胆管癌的患者32例,采用西门子双源CT平扫后对靶平面行灌注扫描,将所得数据传至双源CT后处理工作站,利用软件生成彩色灌注图和时间-密度曲线（TDC）,观察TDC的形态及走势,测量各病例病变组织的血流量（BF）,血容量BV）,达峰时间（TTP）,通透性（permeability,per）及Patlak血容量（pBV）等灌注参数,对所测得数据进行统计。结果32例接受检查的患者中经临床诊断证实为胆管癌的有27例,其中16例获得了手术病理结果。27例肝外胆管癌按大体部位可分为肝门部胆管癌、胆总管中段癌及胆总管下段癌。胆管癌组织的灌注参数如下：BF（69.7±25.2）,BV（115.0±36.8）,PS（58.7±22.8）及pBV（56.2±23.6）。胆管癌TDC表现为峰值出现于25秒至35秒以内,然后曲线平缓下降的特点。同时分析16例有病理分型的肝外胆管癌的灌注结果,高分化癌比中低分化癌组织的BV值高（P＆lt;0.05）。结论C...

Initial Study of CT Perfusion Using DSCT in extrahepatic cholangiocarcinoma

Objective To determine the value of DSCT dynamic enhancemengt scanning in extrahepatic cholangiocarcinoma, and the value of perfusion computed tomography （CT） in diagnosis of extrahepatic cholangiocarcinoma. Methods Perfusion CT was performed in 32 patients who were suspected as extrahepatic cholangiocarcinoma. Get a time-density-curve from the perfusion data. Measure and compare the flow, blood volume （BV）, permeability（per） and Patlak blood volume（pBV） of the lesion. Results The perfusion parameters of the lesion were BF（69.7 ± 25.2）, BV（115.0 ± 36.8）, PS（58.7 ±22.8） and pBV（56.2 ± 23.6）. The values of BV may have a relationship with the pathologic typing. TDC of extrahepatic cholangiocarcinoma is different from that of normal biliary wall. Conclusion CT perfusion may improve the diagnosis of extrahepatic angiocarcinoma.