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目的使用容积螺旋CT灌注成像方法测量直肠癌患处的局部二维/三维血流分布分形属性,并评估该方法的结果再现性。材料与方法本研究获得制度审查委员会的批准和相关人员的知情同意。在本研究中,研究人员选取了10位疑似直肠腺癌患者(8男2女,平均年龄72.3岁),在不进行介入治疗的情况下,24 h对选取的患者进行了2轮容积螺旋CT灌注成像(四维可调螺旋成像模式,z轴覆盖范围为11.4 cm),并通过反卷积方法计算得到直肠癌患部的局部血流信息。研究人员通过设定信号强度阈值,将肿瘤区域从背景信号中划分出来之后,对该区域进行了二维和三维分形分析,依此确定分形分析的分形维数和丰度。研究人员还使用Bland-Altman统计方法对统计结果的再现性进行定量评估,并利用二维和三维的缺项散点图定性评估结果再现性。统计显著性水平为5%。结果平均血液流速为63.50 mL/min/100 mL±8.95(标准差)。在重复多次的实验中,分形维数的分析结果具有良好的一致性;二维分形分析的平均差值为-0.024(95%一致性的平均差值界限:-0.212,0.372),三维分形分析的平均差为-0.024(95%一致性的平均差值界限:-0.307,0.355)。二维分形分析的分形丰度的平均差为-0.355(95%一致性的平均差值界限:-0.869,1.579),三维分形分析的分形丰度的平均差为-0.043(95%一致性的平均差值界限:-1.154,1.239)。三维分析中的95%一致性的平均差值界限比二维分析的窄。缺项散点图也直观地证实了多次试验结果之间的一致性。结论直肠癌的局部血流情况显示出了分形属性。对该区域的成像结果进行的二维/三维分形分析的结果具有良好的再现性。
Objective To measure the local two-dimensional / three-dimensional distribution of blood flow fractures in patients with rectal cancer by volume spiral CT perfusion imaging and evaluate the reproducibility of the results. Materials and Methods The study was approved by the institutional review board and the informed consent of relevant personnel. In this study, the researchers selected 10 patients suspected of rectal adenocarcinoma (8 males and 2 females, mean age 72.3 years), without interventional treatment, the patients were selected 24-hour volume spiral CT Perfusion imaging (four-dimensional adjustable spiral imaging mode, the z-axis coverage range of 11.4 cm), and by deconvolution method to calculate the local blood flow in the affected area of rectal cancer. After setting the signal intensity threshold, the researchers divided the tumor area from the background signal and performed two-dimensional and three-dimensional fractal analysis of the region to determine the fractal dimension and abundance of the fractal analysis. The researchers also used Bland-Altman statistical methods to quantitatively evaluate the reproducibility of statistical results and qualitatively evaluate the reproducibility of results using two-dimensional and three-dimensional missing scattergrams. The statistical significance level is 5%. Results The mean blood flow was 63.50 mL / min / 100 mL ± 8.95 (standard deviation). In repeated experiments, the fractal dimension analysis results showed good agreement; the average difference of two-dimensional fractal analysis was -0.024 (95% agreement of the mean difference limit: -0.212,0.372), three-dimensional fractal The mean difference for the analysis was -0.024 (95% consensus mean margin difference: -0.307, 0.355). The average difference of fractal abundance in two-dimensional fractal analysis was -0.355 (mean difference limit of 95% agreement: -0.869, 1.579), and the average difference of fractal abundance in three-dimensional fractal analysis was -0.043 (95% agreement Average margin of difference: -1.154,1.239). The 95% agreement in the three-dimensional analysis of the mean difference limit is narrower than the two-dimensional analysis. The lack of scatter plots also intuitively confirmed the consistency between multiple test results. Conclusion The local blood flow in rectal cancer shows fractal properties. The results of the two-dimensional / three-dimensional fractal analysis of the imaging results of this area have good reproducibility.