低剂量 CT 灌注成像在乳腺癌与乳腺纤维腺瘤中的应用研究。

Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China.

Department of Radiology, Affiliated Hospital of Jiangnan University, The Forth People's Hospital of Wuxi City, Wuxi, Jiangsu, China.

J Xray Sci Technol. 2018;26(4):681-690. doi: 10.3233/XST-18377.

PURPOSE

To explore the characteristics of breast cancer and breast fibroadenoma using low-dose computed tomography perfusion imaging (LDCTPI) including specific perfusion parameter values, and seek the potential clinical applications in cancer prognosis assessment.

MATERIALS AND METHODS

Fifty patients including 30 diagnosed with breast cancer and 20 with breast fibroadenoma, as well as 15 control subjects with normal breasts were studied prospectively using LDCTPI examinations. The acquired volumetric imaging data were used for calculation, mapping and analysis by using a body tumor perfusion protocol in the CT perfusion software to measure 4 parameters: blood flow (BF), blood volume (BV), mean transit time (MTT), and the permeability surface (PS) area product. Statistical data analysis was then performed to distinguish the difference of the 4 parameter values among normal control, breast cancer and breast fibroadenoma cases.

RESULTS

The mean perfusion values of 15 normal controls were as follows: BF, 20.03±4.08 mL/100 g/min; BV, 4.53±0.95 mL/100 g; MTT, 5.90±0.82 s; and PS, 9.25±1.18 mL/100 g/min. The mean perfusion values of 30 cancer patients were as follows: BF, 56.67±6.59 mL/100 g/min; BV, 5.82±0.68 mL/100 g; MTT, 6.01±0.82 s; and PS, 24.95±5.05 mL/100 g/min. The mean perfusion values of 20 patients with breast fibroadenoma were as follows: BF, 46.24±6.65 mL/100 g/min; BV, 5.07±0.73 mL/100 g; MTT, 7.51±0.62 s; and PS, 16.73±6.48 mL/100 g/min. Comparing the 3 groups, differences were all statistically significant for BF, BV, MTT and PS values (p < 0.05, respectively); The BF, BV, PS values were highest in group of cancer patients, while the MTT value was highest in group of patients diagnosed with breast fibroadenoma.

CONCLUSION

Breast CT perfusion imaging is a promising functional imaging technology in breast cancer diagnosis, which can provide valuable quantitative imaging markers to assist evaluation of breast tumors.

目的

利用低剂量 CT 灌注成像（LDCTPI）探索乳腺癌和乳腺纤维腺瘤的特征，包括特定的灌注参数值，并寻找在癌症预后评估中潜在的临床应用。

材料与方法

前瞻性地对 50 例患者（包括 30 例乳腺癌和 20 例乳腺纤维腺瘤患者）和 15 例正常乳房的对照患者进行 LDCTPI 检查。使用体肿瘤灌注方案，通过 CT 灌注软件对采集的容积成像数据进行计算、映射和分析，以测量 4 个参数：血流（BF）、血容量（BV）、平均通过时间（MTT）和通透性表面（PS）面积乘积。然后对这些参数在正常对照组、乳腺癌组和乳腺纤维腺瘤组中的差异进行统计学数据分析。

结果

15 例正常对照组的平均灌注值如下：BF，20.03±4.08mL/100g/min；BV，4.53±0.95mL/100g；MTT，5.90±0.82s；PS，9.25±1.18mL/100g/min。30 例癌症患者的平均灌注值如下：BF，56.67±6.59mL/100g/min；BV，5.82±0.68mL/100g；MTT，6.01±0.82s；PS，24.95±5.05mL/100g/min。20 例乳腺纤维腺瘤患者的平均灌注值如下：BF，46.24±6.65mL/100g/min；BV，5.07±0.73mL/100g；MTT，7.51±0.62s；PS，16.73±6.48mL/100g/min。BF、BV、MTT 和 PS 值在三组之间的差异均有统计学意义（p<0.05）；乳腺癌患者组 BF、BV、PS 值最高，而乳腺纤维腺瘤患者组 MTT 值最高。