多层螺旋CT灌注成像在脑肿瘤诊断中的临床研究

目的: 探讨多层螺旋CT(multislice spiral CT,MSCT)脑肿瘤灌注成像方法及其临床应用价值.材料和方法: 对27例脑肿瘤先用常规CT平扫确定肿瘤中心实质部位,然后进行MSCT灌注扫描.扫描图像经ADW4.0工作站PerfusionⅡ软件进行计算,得出灌注图像及参数,包括脑血流量(CBF)、脑血容量(CBV)、造影剂平均通过时间(MTT)和肿瘤微血管表面通透性(PS).结果: 27例中,脑胶质瘤7例、脑膜瘤8例、脑转移瘤8例、颅咽管瘤2例,淋巴瘤、血管母细胞瘤各1例.27例灌注图像均可以清晰显示肿瘤的大小、轮廓,清晰地区分肿瘤和水肿;不同类型肿瘤的CBF、CBV、MTT及PS值不尽相同,灌注伪彩图表现不同;PS图能清晰显示脑肿瘤的实质部分及微血管通透性.结论: MSCT灌注成像对脑肿瘤血流灌注的定量研究提供了新的方法,对了解脑肿瘤内部血流状态及微血管通透性的改变有一定的价值.

The Preliminary Study of Perfusion Imaging in Brain Tumor with Multislice Spiral CT

Purpose: To investigate the methods and clinical value of MSCT perfusion imaging(MSCTPI) in the brain tumors.Materials and Methods: Conventional CT was performed first to confirm the central part of tumor,,then film-scanning technique of MSCTPI was used in the patients with brain tumor.The scanning images were calculated by software Perfusion2 in ADW4.0 workstation to get perfusion images and data,including Cerebral Blood Flow(CBF), Cerebral Blood Volume(CBV), Mean Transit Time(MTT) and permeability surface(PS). Results: In 27 brain tumors there were 7 Astrocytomas,8 Meningiomas,8 Metastatic Tumors,2 Craniopharygiomas,1 Lymphoma and 1 Hemangioblastoma.All perfusion images could clearly display brain tumors and easily know the difference between tumor and edema.The values of CBF,CBV,MTT,PS were different in different tumor and PS images could clearly display essential part of brain tumors and capillary permeability. Conclusion: MSCTPI provides a new method in quantificational research of brain tumor flow perfusion and is valuable in realizing inner flow state of brain tumor and change of capillary permeability.