Sun Zong-Qiong, Cheng Xiao-Fang, Ge Yu-Xi, Chen Lin, Yue Jian-Guo, Jin Lin-Fang, Xie Zhi-Hui, Zhang Han-Di, Xuan Ying-Hua
Department of Radiology, Affiliated Hospital of Jiangnan University, The Forth People's Hospital of Wuxi City, Wuxi, Jiangsu, China.
Department of Radiology, Guanzhou Hui-Ai Hospital, Guangzhou, Guangdong, China.
J Xray Sci Technol. 2015;23(6):737-44. doi: 10.3233/XST-150524.
To explore the characteristics of variously differentiated gastric cancers on computed tomography (CT) perfusion imaging, including specific perfusion parameter values, and potential clinical applications in the prognosis assessment of gastric cancer.
Fifty patients with gastric cancer confirmed by gastroscope pathology were studied prospectively using CT perfusion imaging examinations on a 64-slice spiral CT scanner. The acquired volume data were used for calculations, mapping, and analysis by using an abdominal tumor perfusion protocol (deconvolution method) in the CT perfusion software package to measure 4 parameters: blood flow (BF), blood volume (BV), mean transit time (MTT), and the permeability surface (PS) area product. The different differentiated Gastric cancers with CT perfusion values were divided into 3 groups: well-differentiated, moderately differentiated and poorly differentiated gastric adenocarcinoma, and compared statistically with one another by statistical software.
The mean perfusion values of 10 patients with well-differentiated gastric adenocarcinoma were as follows: BF, 75.28 ± 6.81 mL/100 g/min; BV, 9.01 ± 0.94 mL/100 g; MTT, 9.89 ± 1.65 s; and PS, 10.05 ± 0.71 mL/100 g/min. The mean perfusion values of 24 patients with moderately differentiated gastric adenocarcinoma were as follows: BF, 110.01 ± 31.90 mL/100 g/min; BV, 18.18 ± 5.62 mL/100 g; MTT, 9.81 ± 3.69 s; and PS, 40.08 ± 15.82 mL/100 g/min. The mean perfusion values of 16 patients with poorly differentiated gastric adenocarcinoma were as follows: BF, 138.59 ± 38.09 mL/100 g/min; BV, 21.08 ± 4.11 mL/100 g; MTT, 9.47 ± 1.80 s; and PS, 57.50 ± 13.28 mL/100 g/min. Comparing the 3 groups, differences between the well-differentiated group and the moderate differentiation group were all statistically significant for BF, BV, and PS (p < 0.05, respectively), differences between the well-differentiated group and the poor differentiation group were all statistically significant for BF, BV, and PS (p < 0.05,respectively) as well; While MTT value showed no statistical difference among the 3 groups (p > 0.05).
Stomach CT perfusion imaging is a functional imaging technology from the perspective of hemodynamics with potential clinical applications. The BF, BV and PS values could serve as indicators of the degree of malignancy and aid in prognostic assessment of gastric cancer.
探讨不同分化程度的胃癌在计算机断层扫描（CT）灌注成像中的特征，包括特定的灌注参数值，以及在胃癌预后评估中的潜在临床应用。
对50例经胃镜病理确诊的胃癌患者进行前瞻性研究，使用64层螺旋CT扫描仪进行CT灌注成像检查。获取的容积数据通过CT灌注软件包中的腹部肿瘤灌注协议（去卷积法）进行计算、绘图和分析，以测量4个参数：血流量（BF）、血容量（BV）、平均通过时间（MTT）和通透表面积（PS）乘积。将具有CT灌注值的不同分化程度的胃癌分为3组：高分化、中分化和低分化胃腺癌，并通过统计软件进行相互间的统计学比较。
10例高分化胃腺癌患者的平均灌注值如下：BF为75.28±6.81 mL/100 g/min；BV为9.01±0.94 mL/100 g；MTT为9.89±1.65 s；PS为10.05±0.71 mL/100 g/min。24例中分化胃腺癌患者的平均灌注值如下：BF为110.01±31.90 mL/100 g/min；BV为18.18±5.62 mL/100 g；MTT为9.81±3.69 s；PS为40.08±15.82 mL/100 g/min。16例低分化胃腺癌患者的平均灌注值如下：BF为138.59±38.09 mL/100 g/min；BV为21.08±4.11 mL/100 g；MTT为9.47±1.80 s；PS为57.50±13.28 mL/100 g/min。比较3组，高分化组与中分化组之间在BF、BV和PS方面的差异均具有统计学意义（p均<0.05），高分化组与低分化组之间在BF、BV和PS方面的差异也均具有统计学意义（p均<0.05）；而MTT值在3组之间无统计学差异（p>0.05）。
胃CT灌注成像是一种从血流动力学角度出发的功能成像技术，具有潜在的临床应用价值。BF、BV和PS值可作为恶性程度的指标，有助于胃癌的预后评估。
