16层螺旋CT灌注成像对肺癌放疗疗效评估的临床应用

摘要

目的 探讨16层螺旋CT肺灌注成像在肺癌放射治疗后疗效评估的临床应用价值.方法 对26例肺癌放射治疗前后行16层螺旋CT肺灌注成像.根据肿瘤强化的时间密度曲线(time-density curve,TDC),计算出病灶的灌注值(perfusion value,PV)、血容量(blood volume,BV)、最高增强值(peak enhancement intensity,PEI)、达峰值时间(time to peak,TTP).放疗后的3个月做常规CT检查,以观察肿瘤形态学变化.结果 19例肺癌放疗后,肿瘤PV、PEI值显著降低,TTP升高,放疗后瘤体组织显著缩小或消失,患者症状明显改善.7例放疗前后PV、BV、PE及TTP值均无显著变化,放疗后肿块形态变化不大,患者症状改善不明显.结论 CT灌注成像可定量评价肺癌放疗前后肿瘤血流灌注的改变,并可早期预测肿瘤的放射性治疗效果.%Objective To explore the value of CT perfusion imaging in prediction of lung cancer response to radiation therapy with 16-slice spiral CT. Methods Twenty-six cases with lung cancer underwent CT perfusion imaging with 16-slice spiral CT pre-and post-radiation therapy, the perfusion value(PV) ,blood volume(BV) peak enhancement intensity!PEI) and time to peak(TTP) were calculated based on the time-density curves (TDC) respectively. The unenhanced CT scans were performed to assess the morphologic changes of tumors three months after the radiation therapy. Results The PV.PEI values of the lesions in nineteen cases decreased significantly, while TTP values increased. All of 19 cases showed reduction in tumor volume or tumor dissolved in 3-month follow-up. The values of PV,BV,PE and TTP of the lesions in seven cases between pre-and post-radiation therapy showed no statistical differences, and the tumors in size changed little. Conclusion CT perfusion imaging plays a valuable role in assessment of the tumor-ous blood perfusion before and after the radiation therapy and it can enable us to predict the efficiency resulted from the radiation therapy in lung cancer.