64层螺旋CT灌注成像在食管癌放疗中应用.docVIP

64层螺旋CT灌注成像在食管癌放疗中应用 　【摘要】 目的： 探讨64层螺旋CT灌注成像在食管癌放疗方面的价值。方法： 38例经病理学证实的食管癌患者在放疗前后分别行64层螺旋CT灌注扫描，将放疗前、后的灌注参数进行配对设计t检验。放疗后随访12～18个月,中位时间15个月，再以是否局部复发和（或）转移为标准进行分组，并对各组病例放疗前肿瘤灌注参数进行独立样本t检验。结果： 38例放疗前组织血流量、血容量、表面通透性、平均通过时间、强化峰值分别为(341.2±137.5) ml ·100 g-1·min-1， (10.4±6.8)ml·100 g-1，(28.3±17.1) ml·100 g-1·min-1，(4.3±1.8) s，(55.9±14.7) Hu，放疗灌注后参数分别为(331.4±121.0) ml·100 g-1·min-1，(8.8±5.1)ml·100 g-1， (9.6±8.9)ml·100 g-1·min-1， (3.5±2.0)s， (46.6±13.5)Hu。肿瘤表面通透性,强化峰值差异有统计学意义。其余各参数之间比较差异无统计学意义。复发／转移组与无复发／转移组灌注参数差异无统计学意义。结论： 灌注参数可以定量反映食管癌的微循环特征。放疗前和放疗后肿瘤表面通透性、强化峰值表现为明显减低。灌注参数难以预测肿瘤放疗后复发及转移。 【关键词】 螺旋CT； 食管肿瘤； 灌注成像； 放射治疗 ［Abstract］ Objective: To assess the value of 64slice spiral CT in diagnosis of esophageal carcinoma and prediction. Methods： thirtyeight cases of esophageal carcinoma proved by nasopharyngoscopy biopsy underwent 64slice CT perfusion imaging before radiotherapy, paired samples ttest was used to analys the perfusion parameters of preradiation and postradiation, 38 cases were followed up for 12～18 months，with median of 15 months. The cases were divided into groups according to whether they had local recurrence or/and metastasis. The parameters of those groups before radiotherapy were assessed with independentsample ttest. Results： Before radiotherapy, the tissue blood flow(BF), blood volume(BV),surface permeability(PS), mean transit time(MTT),peak height(PH) of 38 cases were(341.2±137.5) ml ·100 g-1·min-1, (10.4±6.8)ml·100 g-1,(28.3±17.1)ml·100 g-1·min-1, (4.3±1.8) s,(55.9±14.7)Hu. After radiation of 60～64 Gy, these parameters were(331.4±121.0)ml·100 g-1·min-1,(8.8±5.1)ml·100 g-1, (9.6±8.9)ml·100 g-1·min-1,(3.5±2.0) s,(46.6±13.5) Hu respectively on pairedsamples ttest. There was significant difference in PH,PS between per and postradiation data,while there was no statistic significant difference in other parameters. Between the group with recurrence or/and metastasis and other groups, there was no statistic difference in parameters of perfusion b