胰腺局灶性实性病变CT灌注参数特征及不同算法的比较

发布时间：2018-06-15 14:49

本文选题：胰腺实性病变 + CT灌注　；参考：《中国医学科学院学报》2017年01期

【摘要】：目的总结胰腺局灶性实性病变CT灌注参数的特征,评估Deconvolution和Maximum slope+Patlak方法所测得的灌注参数之间的一致性及两种测量方法之间是否可相互替换。方法 2015年12月至2016年11月在北京协和医院行全胰腺CT灌注检查、经术后及穿刺病理证实为胰腺癌(PAC)患者22例和胰腺神经内分泌瘤(p NET)患者22例(共37个病灶),全胰腺CT灌注检查采用管电压80kV、管电流100m A,进行28次连续动态体积扫描,静脉注射45ml碘普罗胺,速率5ml/s,随后追加40ml盐水,速率5ml/s。由1名经验丰富的放射科医师在西门子后处理工作站上分别用Maximum slope+Patlak及Deconvolution method方法进行数据分析,测量并记录其灌注参数。结果 Wilcoxon非参配对秩和检验结果显示,PAC(BFM比BFD,Z=-3.263,P=0.001;BVD比BVP,Z=-3.978,P=0.000)和p NET(BFM比BFD,Z=-5.212,P=0.000;BVD比BVP,Z=-2.633,P=0.008)两种方法所测得的灌注参数之间差异均有统计学意义。Spearman’s相关系数分析结果显示,PAC(BFM与BFD,r=0.845,P=0.000;BVD与BVP,r=0.964,P=0.000)和p NET(BFM与BFD,r=0.759,P=0.000;BVD比BVP,r=0.683,P=0.000)两种方法所测得的灌注参数间均有显著相关性。PAC的BFM/BFD和BVD/BVP几何均数及其95%一致性界限(LOA)分别为0.77(0.61~0.99)和1.42(1.13~1.79),p NET的BFM/BFD和BVD/BVP几何均数及其95%LOA分别为0.66(0.51~0.86)和1.15(0.88~1.50)。结论无论在PAC还是p NET中由Deconvolution和Maximum slope+Patlak方法所测得的灌注参数BF、BV存在显著性差异,两种测量方法之间具有显著相关性,并且两者之间的转换范围较窄,所以两种测量方法之间可以相互替换。
[Abstract]:Objective to summarize the characteristics of CT perfusion parameters in focal solid pancreatic lesions and to evaluate the consistency between the perfusion parameters measured by the Deconvolution and maximum slope Patlak methods and whether the two methods can be replaced by each other. Methods from December 2015 to November 2016, CT perfusion examination of whole pancreas was performed in Peking Union Hospital. There were 22 cases of pancreatic carcinoma and 22 cases of pancreatic neuroendocrine tumor (37 lesions) proved by postoperative and puncture pathology. Ct perfusion examination of the whole pancreas was performed with voltage 80 kV, tube current 100 Ma, continuous dynamic volume scan for 28 times. 45ml was injected intravenously at a rate of 5 ml / s, followed by 40ml saline at a rate of 5 ml / s. The perfusion parameters were measured and recorded by an experienced radiologist using maximum slope Patlak and Deconvolution method methods on Siemens postprocessing workstation. Results the results of Wilcoxon nonparametric paired rank sum test showed that there were significant differences between the perfusion parameters measured by the two methods: the ratio of BFM to BFD-3.263P0. 001and BVD of BVPP0. 978 P0. 000) and the ratio of pNETX BFM to BFDT-5. 212P0. 000BVD to BVPPZ- 2. 633P0.008). The results of correlation coefficient analysis of Spearmanns showed that PACPACBFM and BFDr0. 845 P0. 000 BVD and BVPrr0. 964P0. 000) There was significant correlation between the perfusion parameters measured by the two methods. The geometric mean of BFM / BFD and BVD / BVP / BVP of PAC were 0.770.61 / 0.99) and the geometric mean of BFMBFD and BVDVP / BVP / BVP and their 95% consistency limits were 0.770.91 / 0.99) and 1.42 / 1.131.79pNET respectively. The geometric mean of BFMBFD and BVDVP / BVP and their 95LOA of BVDVP / net were 0.660.510.86) and 1.150.881.50m respectively. Conclusion there is a significant difference in the perfusion parameters BF- BV measured by Deconvolution and maximum slope Patlak methods in both PAC and PNET. There is a significant correlation between the two methods, and the range of conversion between the two methods is narrow. Therefore, the two methods of measurement can be replaced by each other.
【作者单位】：中国医学科学院北京协和医学院北京协和医院放射科;
【基金】：国家自然科学基金(81371608) 卫生公益性行业科研专项项目(201402001、201402019)~~
【分类号】：R576;R816.5

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