Pulido Jose S, Campeau Norbert G, Klotz Ernst, Primak Andrew N, Saba Osama, Gunduz Kaan, Cantrill Herbert, Salomão Diva, McCollough Cynthia H
Department of Ophthalmology.
Clin Ophthalmol. 2008 Jun;2(2):275-81. doi: 10.2147/opth.s2071.
The initial use of a 64-slice computed tomography (CT) scanner for obtaining quantitative perfusion data from a large ciliochoroidal melanoma, and correlation with 3T magnetic resonance imaging (MRI) dynamic enhancement and tumor histology.
The CT perfusion scan was performed using 80 kVp, 250 mA and 1-sec rotation time for 40 sec. The analysis was performed using commercial perfusion analysis software with a prototype 3-dimensional motion correction tool. Dynamic contrast-enhanced 3-Tesla MRI measured the kinetics of enhancement to estimate the vascular permeability. The time-dependent enhancement patterns were obtained using the average signal intensity using Functool analysis software. The involved globe was enucleated and microscopic evaluation of the tumor was performed.
The perfusion parameters blood flow, blood volume and permeability surface area product in the affected eye determined by CT perfusion analysis were 118 ml/100 ml/min, 11.3 ml/100 ml and 48 ml/100 ml/min. Dynamic MRI enhancement showed maximal intensity increase of 111%. The neoplasm was a ciliochoroidal spindle cell melanoma which was mitotically active (13 mitoses/40 hpf). Vascular loops and arcades were present throughout the tumor. The patient developed metastases within 9 months of presentation.
Quantitative CT perfusion analysis of ocular tumors is feasible with motion correction software.
首次使用64层计算机断层扫描（CT）扫描仪从大型睫状体脉络膜黑色素瘤获取定量灌注数据，并与3T磁共振成像（MRI）动态增强及肿瘤组织学进行相关性研究。
CT灌注扫描采用80 kVp、250 mA及1秒旋转时间，持续40秒。使用带有原型三维运动校正工具的商业灌注分析软件进行分析。动态对比增强3特斯拉MRI测量增强动力学以评估血管通透性。使用Functool分析软件通过平均信号强度获取随时间变化的增强模式。摘除患眼并对肿瘤进行显微镜评估。
通过CT灌注分析确定的患眼中灌注参数血流量、血容量和通透表面积乘积分别为118 ml/100 ml/min、11.3 ml/100 ml和48 ml/100 ml/min。动态MRI增强显示最大强度增加111%。肿瘤为睫状体脉络膜梭形细胞黑色素瘤，有丝分裂活跃（每40个高倍视野有13个有丝分裂象）。肿瘤内可见血管袢和血管弓。患者在就诊后9个月内发生转移。
使用运动校正软件对眼部肿瘤进行定量CT灌注分析是可行的。
