低剂量容积CT灌注成像CTA对宫颈癌供血血管的显示效果分析

目的探讨基于盆腔容积CT灌注成像的CTA图像对宫颈癌供血血管的显示价值。方法选取我院86例宫颈癌患者随机分为A、B两组,每组43例。A组行盆腔容积CT灌注扫描,获得髂外动脉的时间密度曲线(TDC),确定髂外动脉达峰时间(TTP),以TTP时相原始图像重建三维CTA图像。B组行数字减影血管造影术(Digital subtraction angiography,DSA)获得血管图像。以DSA图像为金标准,分析低剂量容积CT灌注成像的CTA对宫颈癌供血血管的显示效果。采用Kappa检验,评估两名影像医师分析双侧子宫动脉主干的起源及连续性显示的一致性,同时将卡方检验用于评估两者判定子宫动脉下行分支显示率的差异。结果两名医师对A、B组图像的评分一致性良好(A组Kappa=0.899,P<0.001,B组Kappa=0.782,P<0.001);A、B两组对双侧子宫动脉主干血管的显示情况无统计学差异(甲医师χ^2=0.213,P>0.05;乙医师χ^2=0.343,P>0.05);甲医师对A组B组子宫动脉下行支的显影率分别为97.7%(42/43)和100%(43/43),乙医师对A组B组子宫动脉下行支的显影率分别为95.3%(41/43)和97.7%(42/43)。两名医师对A、B组子宫动脉下行支显影率的评价一致性良好,(A组Kappa=0.656,P<0.001;B组Kappa=0.306,P<0.001);两名医师判定的CTA图像及DSA图像对子宫动脉下行支显影率无统计学差异(甲医师χ^2=1.01,P>0.05;乙医师χ^2=0.345,P>0.05)。结论以DSA图像为标准,基于容积CT灌注成像的CTA可良好地显示宫颈癌供血血管,对双侧子宫动脉主干的起源及连续性和对子宫动脉下行支的显示具有很好稳定性。

Analysis of the effect of CTA on the blood supply of cervical squamous cell carcinoma based on low-dose volumetric CT perfusion imaging

Objective To explore the value of CTA images based on pelvic volume CT perfusion imaging in displaying the blood vessels of cervical cancer.Methods 86 patients with cervical cancer in our hospital were randomly divided into group A and group B,with 43 cases in each group.Pelvic volume CT perfusion scan was performed in group A to obtain the time density curve(TDC)of the external iliac artery,to determine the peak time of the external iliac artery(TTP),and to reconstruct 3 d CTA images with TTP time-phase original images.Blood vessel images were obtained with Digital subtraction angiography(DSA)in group B.Using DSA image as the gold standard,the effect of CTA with low-dose volumetric CT perfusion imaging on the blood vessels of cervical cancer was analyzed.Kappa test was used to evaluate the consistency of the origin and continuity display of bilateral uterine artery trunk analyzed by the two radiologists,and chi-square test was used to evaluate the difference in the display rate of descending uterine artery branch determined by the two radiologists.Results The consistency of the scores of the two physicians on the images of group A and group B was good(Kappa=0.899,P<0.001 in group A)Group B,Kappa=0.782,P<0.001);There was no statistical difference in the display of bilateral main uterine arteries between group A and group B(Physiciansχ^2=0.213,P>0.05).Physicians Bχ^2=0.343,P>0.05).The imaging rate of descending branch of uterine artery of group A and group B by physician A was 97.7%(42/43)and 100%(43/43),and that by physician B was 95.3%(41/43)and 97.7%(42/43),respectively.The 2 physicians'evaluation of descending uterine development in group A and group B was consistent(Kappa=0.656,P<0.001 in group A;Group B Kappa=0.306,P<0.001);The CTA images and DSA images de-termined by the two physicians had no statistical difference in the development rate of descending branch of terine artery(Physicians Aχ^2=1.01,P>0.05;Physicians Bχ^2=0.345,P>0.05).Conclusion Using DSA images as the standard,CTA based on volume-based CT perfusion imaging can well display the blood supply vessels of cervical cancer,and has good stability in the origin and continuity of bilateral main uterine arteries and the display of descending branches of uterine arteries.