全器官CT灌注成像对胰腺癌微循环改变的评价

发布时间：2018-02-03 05:04

本文关键词： 胰腺肿瘤微循环动态容积CT 灌注成像　出处：《大连医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：探讨640层动态容积CT全胰腺低剂量灌注成像技术的应用价值，应用该技术分析不同胰腺疾病的灌注差异，对胰腺癌早期微循环的改变做出判断，为胰腺癌的早期诊断及鉴别诊断提供依据。材料与方法：对21例拟诊胰腺疾病患者和9例健康志愿者（男性26例，女性4例，年龄24岁-73岁，平均年龄51岁）行胰腺全器官低剂量CT灌注成像检查。根据患者身体重量指数（Body Mass Index）以6-8ml/s的注射速度使用双筒高压注射器经右肘静脉顺序团注优维显30-40m（l370mg iodine/ml）与生理盐水30ml，同步应用东芝640层容积CT（Aquilin-ONE）进行胰腺全器官CT灌注扫描。对采集的容积数据进行对位处理和灌注分析，采用最大斜率法获取感兴趣区的时间-密度曲线、血流灌注图、组织血流量等灌注参数。应用SPSS13.0软件进行统计分析。结果：所有受试者均完成全胰腺低剂量CT灌注成像检查。其中包括胰腺癌11例；急性胰腺炎6例，其中伴有胰头坏死1例；4例慢性胰腺炎中1例伴有胰腺假囊肿形成；正常胰腺9例。正常胰腺组织动脉血流量为117.04±12.05ml/min/100ml，胰腺炎组织动脉血流量为118.67±37.18ml/min/100ml，，胰腺癌组织动脉血流量为67.16±18.94ml/min/100ml(F=8.59, p=0.0004)。胰腺癌组与正常胰腺组及胰腺炎组有明显统计学差异(p0.05)，且血流灌注图中可以明确显示该差异；正常胰腺组与胰腺炎组之间无明显统计学差异(p0.05)。X射线的总剂量约为21.5-23.9mSv。结论：在对患者进行细致地检查前准备和充分地呼吸训练基础上，配合合理的对比剂浓度、剂量及团注速度、扫描参数和后处理方法等，胰腺全器官低剂量CT灌注成像可取得良好的检查结果及灌注数据，并能有效评价胰腺疾病的血流动力学改变，对胰腺癌的早期诊断及鉴别诊断有重要潜在价值。
[Abstract]:Objective: to evaluate the application value of 640slice dynamic volume CT low-dose perfusion imaging of whole pancreas, analyze the difference of perfusion in different pancreatic diseases, and judge the changes of microcirculation in early stage of pancreatic cancer. To provide evidence for early diagnosis and differential diagnosis of pancreatic cancer. Materials and methods: 21 patients with pancreatic diseases and 9 healthy volunteers (male 26, female 4, aged 24 to 73 years) were studied. Low dose CT perfusion imaging of the whole pancreas. Body Mass index based on body mass index (BMI). The injection rate of 6-8 ml / s was injected with a double-tube high-pressure syringe through the right elbow vein in a sequential group of 30-40mL ~ 370mg iodine / ml and 30ml saline. The CT perfusion scanning of the whole pancreas was performed with Toshiba 640 slice volume CTAquilin-ONE.The volume data were processed and perfused. The time-density curve, perfusion graph and tissue blood flow of the region of interest were obtained by the maximum slope method. The statistical analysis was carried out with SPSS13.0 software. Results: all subjects completed low-dose CT perfusion imaging of the whole pancreas, including 11 cases of pancreatic cancer. There were 6 cases of acute pancreatitis, including 1 case with pancreatic head necrosis. Among 4 cases of chronic pancreatitis, 1 case was accompanied by pancreatic pseudocyst formation. The arterial blood flow of normal pancreas was 117.04 卤12.05 ml / min / 100 ml. The arterial blood flow was 118.67 卤37.18ml / min / 100ml. The arterial blood flow of pancreatic carcinoma was 67.16 卤18.94 ml / min / 100 ml / min / 100 ml / min respectively. There was significant difference between pancreatic cancer group and normal pancreas group and pancreatitis group. There was no significant difference between normal pancreas group and pancreatitis group. The total dose of X ray was about 21.5-23.9mSv. Conclusion: on the basis of careful preparation before examination and adequate breathing training, reasonable contrast agent concentration, dose and mass injection rate, scanning parameters and post-treatment methods were used. Low-dose CT perfusion imaging of pancreatic organs can obtain good results and perfusion data, and can effectively evaluate the hemodynamic changes of pancreatic diseases. It has important potential value in early diagnosis and differential diagnosis of pancreatic cancer.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.6;R735.9

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