能谱CT评估非小细胞肺癌经皮氩氦刀冷冻消融术疗效

发布时间：2018-03-08 19:11

本文选题：体层摄影术　切入点：X线计算机　出处：《中国医学影像技术》2015年08期 　论文类型：期刊论文

【摘要】：目的探索能谱CT成像对非小细胞肺癌氩氦刀冷冻消融术疗效评估的应用价值。方法收集接受CT引导下氩氦刀冷冻消融术的非小细胞肺癌患者23例(30次),于术前及术后(1~3个月)行GSI模式增强CT扫描,测量/计算手术前后病灶最大面积(S)、最大径(L)、强化区最大径(LE)、中心区和边缘区CT均值及碘含量均值变化率;分析WHO、RECIST、mRECIST标准及CTm-rec、Im-rec标准下,完全缓解(CR)、部分缓解(PR)、情况稳定(SD)、病情进展(PD),有效(CR+PR)、无效(SD+PD)患者的1年期生存率及整体生存期(OS)差异。结果 WHO、RECIST、mRECIST及CTm-rec标准下,1年期生存率随疗效变差而下降。RECIST标准下PR、SD、PD患者的OS差异有统计学意义(P=0.02);RECIST、mRECIST标准下SD与PD患者、CTm-rec标准下PR与PD患者、Im-rec标准下PR与SD患者的OS差异均有统计学意义(P=0.01、0.04、0.03、0.03)。CTm-rec及Im-rec标准下有效与无效患者的OS差异有统计学意义(P=0.04、0.03)。结论 Im-rec标准更敏感,CTm-rec标准可对术后病灶复发进行预测。能谱CT多参数联合应用有助于对非小细胞肺癌氩氦刀冷冻消融术后疗效的早期、全面评估。
[Abstract]:Objective to explore the value of energy dispersive CT imaging in the evaluation of therapeutic effect of argon-helium ablation for non-small cell lung cancer. Methods 23 patients with non-small cell lung cancer received CT-guided cryopreservation and ablation with argon-helium knife were collected 30 times before operation and 30 times before operation. GSI mode enhanced CT scan was performed 1 ~ 3 months after operation. The mean value of CT and iodine content in central and marginal areas were measured / calculated before and after operation, and the mean value of CT and iodine content in central and marginal areas were measured and calculated, and the changes of CT mean value and iodine content in central and marginal areas were analyzed under the standard of WHOORECIST and CTm-recrecn Im-rec. The 1-year survival rate and overall survival time of patients with complete remission and partial remission were significantly different from those of patients with complete remission and partial remission. Results the 1-year survival rate decreased with the deterioration of curative effect under the criteria of WHOORECISM RECIST and CTm-rec. The difference of OS between PR and PD patients under RECIST standard is statistically significant. There are significant differences in OS between SD and PD patients under RECIST standard and that in PD patients under the standard of CTm-rec. The OS differences between PR and SD patients under the standard of PR and PD are statistically significant. Conclusion the Im-rec standard is more sensitive than CTm-rec standard in predicting postoperative recurrence. The combined use of multiple parameters of EDS CT is helpful for the early treatment of non-small cell lung cancer after cryopreservation and ablation with argon-helium knife. Comprehensive assessment
【作者单位】：北京中医药大学东方医院放射科;北京中医药大学东方医院肿瘤科;
【基金】：北京市丰台区卫生系统研究项目
【分类号】：R734.2;R730.44

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