低剂量CT灌注成像在进展期胃癌新辅助化疗疗效评价中的价值

发布时间：2018-01-19 18:36

本文关键词： CT灌注成像低剂量进展期胃癌新辅助化疗病理反应　出处：《临床放射学杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的探讨低剂量CT灌注成像(LDCTPI)的灌注参数值在进展期胃癌患者新辅助化疗疗效评价中的价值。方法对30例进展期胃癌患者在化疗前后分别进行LDCTPI检查(120 k V,50 m As),并测取肿瘤区CT灌注参数血流量(BF)及血容量(BV)值;所有患者接受化疗(ECF方案)2个疗程,化疗结束后1周内进行手术切除肿瘤,并取得术后病理疗效分级结果;采用配对样本t检验比较BF及BV值在胃癌化疗前后的差异性,使用Spearman检验分析胃癌化疗后BF及BV值减少率与病理疗效分级之间的相关性,再制作受试者工作特征(ROC)曲线,计算曲线下面积(AUC),并找出预测胃癌化疗有效的BF及BV值减少率截值。结果 BF及BV值在胃癌化疗前后均有显著统计学差异(P0.01),胃癌化疗后BF值减少率及BV值减少率与病理疗效分级均呈显著相关(r=0.660,P=0.000;r=0.706,P=0.000)。如果将BF值下降12.1%(ROC曲线AUC为0.816,P=0.005)作为评价胃癌化疗有效的截值,其敏感度是82%,特异度是84%;将BV值下降32.8%(ROC曲线AUC为0.844,P=0.002)作为评价胃癌化疗有效的截值,其敏感度是82%,特异度是89%。结论 CT灌注参数BF、BV值减少率可以作为预测胃癌化疗疗效的评估指标。
[Abstract]:Objective to investigate the low dose of CT perfusion imaging (LDCTPI) of the perfusion parameters in the efficacy of neoadjuvant chemotherapy for advanced gastric cancer in the evaluation value. Methods 30 cases of advanced gastric cancer patients before and after chemotherapy were examined by LDCTPI (120 K V, 50 m As), and measured the CT perfusion parameters of blood flow in the tumor area (BF) and blood volume (BV); all patients received chemotherapy (ECF regimen) 2 treatment, surgical resection of tumor in 1 weeks after the end of chemotherapy and postoperative pathological classification efficacy results; differences in gastric cancer before and after chemotherapy by paired sample t test to compare BF and BV values, analysis of gastric cancer after chemotherapy BF and BV reduce the value of correlation between the classification rate and pathological effect using Spearman test, then the receiver operating characteristic (ROC) curve, calculate the area under the curve (AUC), and find out the prediction of BF and BV in gastric cancer chemotherapy effectively reduce the value of rate cut values. The results of BF and BV in gastric cancer There was a statistically significant difference before and after chemotherapy (P0.01), gastric cancer after chemotherapy BF value decrease rate and BV value decrease rate and pathological classification efficacy were significant (r=0.660, P=0.000; r=0.706, P=0.000). If the BF value decreased by 12.1% (ROC curve of AUC was 0.816, P=0.005) as the evaluation of gastric cancer chemotherapy effectively cut value. The sensitivity is 82%, specificity is 84%; the BV value decreased by 32.8% (ROC curve of AUC was 0.844, P=0.002) as the evaluation of chemotherapy effective cut-off value, the sensitivity is 82%, specificity is 89%. conclusion CT perfusion parameters BF, BV value decrease rate can be used as evaluation index of gastric cancer prediction.

【作者单位】：江南大学附属医院(无锡市第四人民医院)放射科;江南大学附属医院(无锡市第四人民医院)介入科;江南大学附属医院(无锡市第四人民医院)病理科;
【基金】：无锡市卫计委科研面上项目(编号:MS201643) 无锡市医管中心青年项目(编号:YGM1123) 江苏省卫计委科研青年项目(编号:Q201615) 江南大学公共卫生研究中心立项(编号:12860102421506400)
【分类号】：R730.44;R735.2
【正文快照】： 本研究系无锡市卫计委科研面上项目(编号:MS201643);无锡市医管中心青年项目(编号:YGM1123);江苏省卫计委科研青年项目(编号:Q201615);江南大学公共卫生研究中心立项(编号:12860102421506400)。作者单位:214062无锡,江南大学附属医院(无锡市第四人民医院)放射科(孙宗琼、王惠

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