中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (08): 630-633.

• 专题笔谈 • 上一篇    下一篇

灌注CT在胰头部肿块定性诊断中的应用

陈克敏林晓珠   

  1. 上海交通大学医学院附属瑞金医院放射科,上海200025
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-08-01 发布日期:2009-08-01

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-08-01 Published:2009-08-01

摘要:

随着多层螺旋CT的发展和应用,CT灌注成像应用于临床已成为可能。CT灌注成像是基于CT同层动态增强技术的CT功能成像,它可以提供活体组织的血流动力学参数。目前CT灌注成像在胰腺的应用研究主要集中于正常胰腺组织、胰腺癌及胰腺内分泌肿瘤等。胰腺癌的CT灌注特征是血流量和血容量均低于正常胰腺组织,表现为乏血供肿瘤。胰腺内分泌肿瘤具有较高的血流量和血容量,且血流量的高低与肿瘤的新生血管形成、WHO分级及增生指数具有很强的相关性。但是表面通透性的研究结果在各中心之间差异较大,可能与所用的CT灌注的数学模型不同以及该项技术本身的不完善有关,故CT灌注成像的全面临床应用尚待时日,需要更大样本、更多中心的实验及临床研究。

关键词: 多层CT, 灌注, 胰腺癌, 胰腺内分泌肿瘤

Abstract:

CT perfusion imaging of pancreatic head mass Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China Corresponding author: CHEN Ke-min, E-mail: keminchenrj @yahoo.com.cn Abstract Computed tomography (CT)-based assessment of tissue perfusion is now possible because of multidetector technology, and most scanners now include software for perfusion analysis. Perfusion CT is a clinical technique that can be used to provide regional maps and obtain quantitative measurements of various hemodynamic parameters on the basis of the linear relationship between CT enhancement and iodinated contrast material concentration. Pancreatic perfusion CT imaging has been applied to the normal tissue of pancreas, the pancreatic cancer, and the pancreatic endocrine tumors. Pancreatic adenocarcinoma is referred to as a hypovascular tumor and this is reflected by the small blood volume values and lower blood flow values in the tumor. In pancreatic endocrine tumors, values of blood volume and blood flow were higher in the tumors than normal pancreatic tissue, and blood flow was strongly correlated with MVD. Perfusion CT measurements are correlated with histoprognostic factors, such as proliferation index and WHO classification. There were some discrepancies in PS values of normal pancreatic tissue and pancreatic tumors between different studies, which perhaps because of the different perfusion CT models and the defect of this technique. To obtain more conclusive results as to the utility of this approach and its optimization, further studies in a larger patient population with use of different perfusion models are needed.

Key words: multidetector CT , perfusion, pancreatic adenocarcinoma, pancreatic endocrine tumors