64 层 CT 灌注成像在胰腺腺癌和肿块型胰腺炎中的应用。

64-slice CT perfusion imaging of pancreatic adenocarcinoma and mass-forming chronic pancreatitis.

机构信息

Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Acad Radiol. 2011 Jan;18(1):81-8. doi: 10.1016/j.acra.2010.07.012. Epub 2010 Oct 15.

DOI:10.1016/j.acra.2010.07.012

PMID:20951612

Abstract

RATIONALE AND OBJECTIVES

To investigate 64 computed tomography (CT) perfusion imaging features of patients with pancreatic cancer and mass-forming chronic pancreatitis.

MATERIALS AND METHODS

Between January 2003 and April 2010, 234 patients with pancreatic mass underwent 64-CT perfusion imaging. Among them, the histopathological results of 64 patients were proven to be pancreatic adenocarcinoma and 15 patients were proven to be mass-forming chronic pancreatitis. Additionally, CT perfusion imaging was performed in 33 healthy volunteers served as controls. The slice data were processed using CT perfusion software. Perfusion parameters including time density curve, blood flow, blood volume, permeability, peak enhancement, and time to peak were recorded.

RESULTS

Blood flow was 77% lower in patients with pancreatic adenocarcinoma than in controls, 48% lower in patients with mass-forming chronic pancreatitis than in controls, and 56% lower in patients with pancreatic adenocarcinoma than with mass-forming chronic pancreatitis (P < .016). Blood volume was 65% lower in pancreatic adenocarcinoma than in controls, 27% lower in mass-forming chronic pancreatitis than in controls, and 53% lower in cancer than mass-forming chronic pancreatitis (P < .016). Permeability was 559% higher in pancreatic adenocarcinoma than in controls, 821% higher in mass-forming chronic pancreatitis than in controls, and 28% lower in cancer than mass-forming chronic pancreatitis (P < .016). Peak enhancement was 27% lower and time to peak 23% longer in pancreatic adenocarcinoma than mass-forming chronic pancreatitis (P < .016). Time-density curve showed the peak of mass-forming chronic pancreatitis is earlier and higher than that of pancreatic adenocarcinoma, and the peak of mass-forming chronic pancreatitis is later and lower than that of controls.

CONCLUSION

CT perfusion imaging can provide additional quantitative hemodynamic information of pancreatic adenocarcinoma and mass-forming chronic pancreatitis.

摘要

目的

研究胰腺占位性病变中胰腺癌和肿块型胰腺炎的 64 层 CT 灌注成像特点。

材料与方法

2003 年 1 月至 2010 年 4 月，对 234 例胰腺占位患者行 64 层 CT 灌注成像检查，其中胰腺癌 64 例，肿块型胰腺炎 15 例，同时选取 33 例健康志愿者作为对照组，利用 CT 灌注软件处理图像。测量并记录时间密度曲线、血流量、血容量、渗透性、峰值强化和达峰时间等灌注参数。

结果

胰腺癌组血流量明显低于对照组（77%）、肿块型胰腺炎组（48%），而胰腺癌组血流量又明显低于肿块型胰腺炎组（56%）；胰腺癌组血容量明显低于对照组（65%）、肿块型胰腺炎组（27%），而胰腺癌组血容量又明显低于肿块型胰腺炎组（53%）；胰腺癌组渗透性明显高于对照组（559%）、肿块型胰腺炎组（821%），而胰腺癌组渗透性又明显低于肿块型胰腺炎组（28%）；胰腺癌组峰值强化明显低于肿块型胰腺炎组（27%）、达峰时间明显长于肿块型胰腺炎组（23%）；时间密度曲线表现为肿块型胰腺炎的峰值明显早于胰腺癌，峰值高于胰腺癌，峰值又明显晚于对照组。