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目的:探讨人脑胶质瘤256层CT灌注成像的可行性并研究胶质瘤的灌注特点。方法:2010年1月—2012年2月行脑256层CT灌注成像扫描受检者55例,其中健康者15例(对照组),胶质瘤患者40例[包括低级别胶质瘤15例(低级别胶质瘤组)、高级别胶质瘤25例(高级别胶质瘤组)]。采用MIStar后处理软件,在病灶最大层面选取感兴趣区(region of interest,ROI),获得ROI的脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)、平均通过时间(mean transittime,MTT)和表面通透性等灌注参数。应用方差分析(Analysis of Variance,ANOVA)检验比较对照组、低级别胶质瘤组和高级别胶质瘤组灌注参数的差异。结果:40例胶质瘤患者均经病理证实。高级别胶质瘤组患者的CBF、CBV和表面通透性分别为(51.41±11.60)mL/(100 g.min)、(6.26±1.67)mL/100 g和(5.71±2.22)mL/(min.100 g),均高于低级别胶质瘤组[(32.73±7.06)mL/(100 g.min)、(2.98±0.73)mL/100 g和(2.33±0.47)mL/(min.100 g)];低级别胶质瘤组的CBF、CBV和表面通透性均高于对照组[(21.06±2.06)mL/(100 g.min)、(1.76±0.17)mL/100 g和(0.90±0.07)mL/(min.100 g)],差异均有统计学意义(P均<0.01)。3组MTT比较,差异无统计学意义。表面通透性为2.88 mL/(min.100 g)时,敏感度为96%,特异度为93%;CBV为3.91 mL/100 g时,敏感度为92%,特异度为93%;CBF为38.90 mL/(100 g.min)时,敏感度为92%,特异度为86%。结论:256层CT灌注成像可在一定程度上反映人脑胶质瘤的肿瘤血流动力学情况。
Objective: To investigate the feasibility of 256-slice CT perfusion imaging of human glioma and to study the perfusion characteristics of gliomas. Methods: From January 2010 to February 2012, 55 patients with 256 brain CT perfusion imaging scans were performed, including 15 healthy controls (control group), 40 glioma patients (including 15 low grade gliomas (Low grade glioma group), 25 cases of high grade glioma (high grade glioma group)]. Using MIStar postprocessing software, the region of interest (ROI) was selected at the maximum level of the lesion, and the cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (mean transit time, MTT) and surface permeability and other perfusion parameters. The difference of perfusion parameters between control group, low-grade glioma group and high-grade glioma group was analyzed by Analysis of Variance (ANOVA). Results: 40 cases of glioma patients were confirmed by pathology. The CBF, CBV and surface permeability of high grade glioma group were (51.41 ± 11.60) mL / (100 g.min), (6.26 ± 1.67) mL / 100 g and (5.71 ± 2.22) mL / ( min (100 g · min), (2.98 ± 0.73) mL / 100 g and (2.33 ± 0.47) mL / (min. 100 g); low-grade glioma group CBF, CBV and surface permeability were higher than the control group [(21.06 ± 2.06) mL / (100 g.min), (1.76 ± 0.17) mL / 100 g and (0.90 ± 0.07) mL / (min.100 g)], the differences were statistically significant (all P <0.01). Three groups of MTT comparison, the difference was not statistically significant. Sensitivity of 96% and specificity of 93% for the surface permeability of 2.88 mL / (min.100 g); sensitivity of 92% and specificity of 93% for CBV of 3.91 mL / 100 g; CBF At 38.90 mL / (100 g.min), the sensitivity was 92% and the specificity was 86%. Conclusion: 256-slice CT perfusion imaging can reflect the tumor hemodynamics of human glioma to a certain extent.