摘要
目的:应用多层螺旋CT灌注成像研究直肠癌放化疗前后肿瘤血管灌注情况,判断各种灌注成像参数与放化疗疗效是否存在相关性。方法:对20例T3、T4期直肠癌患者放化疗前后行2次多层螺旋CT灌注成像,所有病例放化疗前均经肠镜证实,12例放化疗后行手术治疗。CT灌注成像采用64层(GE公司)CT扫描仪,采用动态电影模式扫描,持续约45s所有数据经工作站软件处理,计算组织血流量(blood flow,BF),血容量(blood volume,BV),平均通过时间(mean transittime,MTT),血管表面通透性(vascular permeability-surface area product,PS)。比较直肠正常及肿瘤组织各灌注参数的变化。结果:直肠癌组织BF值明显升高、MTT值明显降低,与正常直肠组织相比具有显著性差异。放化疗后,直肠癌组织BF值明显降低、MTT值明显升高,并具有显著性差异。BF、MTT值在放化疗有效者和无效者之间具有显著性差异,2例放化疗无效患者在放化疗后BF、MTT值无明显变化。结论:多层螺旋CT灌注成像能有效评价直肠癌患者放化疗前后肿瘤血管灌注情况的变化,对判断直肠癌放化疗疗效具有重要价值。
Objective： To use multi-slice computed tomograpby （CT） peffusion to prospectively investigate tumor vaseularity in rectal cancer and to determine whether any of the peffusion parameters would predict tumor response to radiation and chemotherapy therapy. Methods： Perfusion CT of rectal cancer was performed with 64-detector row CT in 20 patients with T3 or T4 rectal cancer. All patients with rectal cancer underwwent 6～8 weeks of chemotherapy and radiation therapy. All the patients were confirmed by endoscope before the therapy, 12 patients followed by surgery. Perfusion CT was repeated after completion of chemotherapy and radiation therapy. Contrast medinm-enhanced dynamic CT was performed with a static table position for 45 seconds, and the data were analyzed by using software to calculate tissue blood flow （BF）, blood volume （BV）, mean transit time （MTT）, and vascular permeability-surface area product. Perfusion parameters of normal rectum and tumor were compared. Perfusion parameters before and after chemotherapy and radiation therapy were compared. Results： Rectal cancer showed higher BF and shorter MTT compared with those of normal rectum. After chemotherapy and radiation therapy, tumors showed significant reduction in BF and increase in MTT. There was a significant difference in BF and MTT values between responders and nonresponders. Tumors in two patients with high initial BF and short MTT showed poor response. Conclusion： Perfusion CT of rectal cancer can enable assessment of tumor vascularity and peffusion changes that result from chemotherapy and radiation therapy. It is important in evaluating the responds of chemotherapy and radiation therapy in rectal cancer.
出处
《医学影像学杂志》
2006年第3期254-257,共4页
Journal of Medical Imaging
关键词
直肠癌
灌注成像
体层摄影术
X线计算机
放化疗
Rectal cancer
Peffusion imaging
Tomography, X-ray computed
Radiation therapy
Chemotherapy
