Revolution CT全肾灌注成像动脉期数据对肾透明细胞癌灌注参数值的影响

目的 探讨Revolution CT全肾灌注成像去除动脉期数据对肾透明细胞癌灌注参数值的影响。方法 回顾性分析接受Revolution CT肾脏增强及灌注扫描、并经手术病理证实为肾透明细胞癌的患者10例。采用Revolution CT机轴扫模式进行灌注扫描，采用CT Perfusion 4D肾脏灌注软件包进灌注成像分析，对所有图像均进行2次后处理，第1次选择所有的灌注数据为A组；第2次去除第9~15期数据，共测量16期，为B组。选择右侧肾门水平腹主动脉为输入动脉，获得血流量（BF）图、血容量（BV）图、平均通过时间（MTT）图及表面通透性（PS）图。分别对比2组肿瘤与正常肾皮质间各灌注参数的差异，并比较A组和B组间肿瘤、正常肾皮质间各灌注参数值的差异。结果 A组和B组中肿瘤较正常肾皮质的BF值及PS值均减低（P均<0.05），BV及MTT值差异均无统计学意义（P均>0.05）。2组病变侧各灌注参数值差异均无统计学意义（P均>0.05），2组正常肾皮质的BF值差异有统计学意义（P=0.009），余灌注参数值差异亦无统计学意义（P均>0.05）。结论 灌注扫描时间为600 s时，去除动脉期数据后测量的肾透明细胞癌各灌注参数值与包含动脉期数据测量的结果无差异，去除动脉期的数据可用于诊断肾透明细胞癌。

Influence of arterial data on Revolution CT perfusion parameters of renal cell carcinoma

Objective To explore the effect of whole-renal perfusion imaging removal of arterial phase data on perfusion parameters of renal clear cell carcinoma using Revolution CT. Methods Perfusion imaging with Revolution CT was retrospectively analyzed in 10 patients with pathologically proven clear cell renal cell carcinoma. The z-direction coverage model was used in perfusion imaging, and the images were analyzed with CT Perfusion 4D software. All images were analyzed twice. All 23 phases data was included in group A and only 16 phases except arterial data (9-15 phases) were selected in group B. The abdominal aorta on the level of right hilus was chosen to be the input artery, and the perfusion parameter maps were obtained, including blood flow (BF), blood volume (BV), mean transit time (MTT), permeability of surface (PS). Every perfusion parameters of lesions and contralateral normal cortex, lesions and normal cortex in both groups were compared. Results The BF and PS of lesions were lower than those of normal cortex in both groups (both P<0.05). There was no statistical difference in BV and MTT between lesions and normal cortex in both groups (all P>0.05). There was no statistical difference in all perfusion parameters of renal clear cell carcinoma between group A and group B (all P>0.05). The difference of BF in normal cortex between the two groups was statistically significant (P=0.009), and the difference of the PS, BV, MTT had no statistically significant (all P>0.05). Conclusion When the duration time of renal CTP is 600 s, there is no difference between including and excluding arterial phase in all perfusion parameters of renal clear cell carcinoma.