MSCT 灌注成像在肾细胞癌临床应用价值研究*

目的:探讨肾细胞癌多层螺旋CT(MSCT)灌注成像特征,并研究其临床应用价值。方法:肾癌患者69例,采用64排多层螺旋CT对其肾脏进行平扫及灌注增强扫描,使用renal tumor perfusion软件对图像进行后处理,自动生成时间-密度曲线(TDC),各种灌注图像及感兴趣区(ROI)内的灌注参数,包括血流量(BF)、血容量(BV)、平均通过时间(MTT)及表面通透性(PS),将得到的灌注参数分别进行统计分析。结果:肾癌肿块灌注参数与已测得的正常肾皮质各灌注参数值均存在显著性差异(P值均<0.01),其中,正常肾皮质的BF值、BV值及PS值均高于肾癌组织,MTT值则相反;肾癌肿块灌注参数与已测得的正常肾髓质各灌注参数值同样存在显著性差异(p值均<0.01),正常肾髓质各灌注参数值均低于肾癌组织,而PS值二者之间差别不显著(P<0.05);肾癌患者健侧肾皮髓质灌注参数值与已测得的正常肾皮髓质各灌注参数值及肾癌患者癌旁正常肾皮髓质各灌注参数值,三者之间差异无统计学意义(P>0.05)。结论:多层螺旋CT(MSCT)灌注成像在显示肾脏形态的同时,还可定量测量皮髓质的血流灌注情况,间接反映肾脏生理特征。

The Value of Muti-slice Spiral Computed Tomography Perfusion Imaging in Diagnosis of Renal Cell Cancer*

Objective: To study the perfusion technique of Multi-slice Sprial Computed Tomography(MSCT) and its clinical application in malignant kidney tumors.Methods: The kidney non-enhenced imaging and perfusion imaging with 64-slice spiral CT were performed in Sixty-eight cases of RCC(renal cell carcinoma).Perfusion parameters of renal including blood flow(BF),blood volume(BV),mean transit time(MTT) and permeability surface(PS)were computed by Perfusion software.Results: The same perfusion parameter between renal cortex and solid components of RCCs,have significant differences(P<0.01).BF value,BV value and PS value of renal cortex is above RCCs,but MTT value is opposite,The perfusion parameters,BF value,BV value and MTT value,between renal medulla and solid components of RCCs have significant difference(P<0.01),but PS value has difference(P<0.05).The same perfusion parameter among contra-lateral healthy kidney of RCCs、renal cortex and medulla and normal renal cortex and medulla of peri-RCCs,have no significant difference(P>0.05).Conclusions: MSCT perfusion techniques can not only show the morphologie changes of the malignant tumors,but also indicate the functional changes of the maligment tumors.The calculation of perfusion data can helpful for the acknowledging its hemodynamic changes,As a convenient,non-invasive exam way.MSCT perfusion techniques should be applied widely in the future.