CAJ | 학술논문

目的评价多层螺旋CT灌注成像(CTP)参数对星形细胞肿瘤分级的敏感性和特异性.方法对第三军医大学第三附属医院野战外科研究所收治的53例脑肿瘤患者进行CTP检查,经手术和病理学证实为星形细胞肿瘤的30例患者纳入研究对象.CTP采用GE LightSpeed 64层螺旋CT机行灌注扫描,在AW4.2P后处理工作站对原始数据进行后处理,测定肿瘤最大灌注区和对侧正常组织的脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)及毛细血管表面通透性(PS).手术获取脑肿瘤标本进行组织病理学检查.结果星形细胞肿瘤高级别组CBF、CBV和PS值均明显高于低级别组,差异有统计学意义(P<0.05),MTT值比较差异无统计学意义(P>0.05).受试者工作特征曲线(ROC曲线)分析表明,CBF、CBV和PS值对鉴别高、低级别星形细胞肿瘤的ROC曲线下面积分别为0.914、0.876和0.914,而MTT无鉴别作用,其ROC曲线下面积为0.455.采用CBF=62.635 mL/(100 g·min),CBV=4.310 mL/100 g和PS=5.925 mL/(100 g·min)作为分界点鉴别高、低级别星形细胞肿瘤的敏感性均为84.2%,特异性分别是81.8%、81.8%和91.9%.结论多层螺旋CTP参数CBF、CBV及PS值对鉴别高、低级别星形细胞肿瘤具有较高敏感性和特异性.
목적 평개다층라선CT관주성상(CTP)삼수대성형세포종류분급적민감성화특이성.방법 대제삼군의대학제삼부속의원야전외과연구소수치적53례뇌종류환자진행CTP검사,경수술화병이학증실위성형세포종류적30례환자납입연구대상.CTP채용GE LightSpeed 64층라선CT궤행관주소묘,재AW4.2P후처리공작참대원시수거진행후처리,측정종류최대관주구화대측정상조직적뇌혈류량(CBF)、뇌혈용량(CBV)、평균통과시간(MTT)급모세혈관표면통투성(PS).수술획취뇌종류표본진행조직병이학검사.결과 성형세포종류고급별조CBF、CBV화PS치균명현고우저급별조,차이유통계학의의(P<0.05),MTT치비교차이무통계학의의(P>0.05).수시자공작특정곡선(ROC곡선)분석표명,CBF、CBV화PS치대감별고、저급별성형세포종류적ROC곡선하면적분별위0.914、0.876화0.914,이MTT무감별작용,기ROC곡선하면적위0.455.채용CBF=62.635 mL/(100 g·min),CBV=4.310 mL/100 g화PS=5.925 mL/(100 g·min)작위분계점감별고、저급별성형세포종류적민감성균위84.2%,특이성분별시81.8%、81.8%화91.9%.결론 다층라선CTP삼수CBF、CBV급PS치대감별고、저급별성형세포종류구유교고민감성화특이성.
Objective To evaluate the sensitivity and specificity of CT perfusion(CTP)parameters in grading the astrocytic tumors.Methods Fifty-three patients with brain tumors underwent CTP examination,and the astrocytie tumors confirmed by operation and pathology(n=30)were selected and divided into high-grade group(n=19)and low-grade group(n=11).Perfusion scanning on the brain was performed by 64-slice spiral CT angiography and the data were analyzed by AW 4.2P software.Cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT)and permeability surface(PS)on the maximum perfusion area and the normal brain tissues in the opposite side were measured.Results High-grade group showed significantly higher CBF,CBV and PS values as compared with the low-grade group(P<0.05).However,the MTT values was not significantly different between the 2 groups(P>0.05).The under-ROC curve areas of the CBF,CBV and PS values between these 2 groups were 0.914,0.876 and 0.914,respectively;while that of MTT was only 0.455 and could not help differentiating the diagnosis.When the optimal limit values of these indicators for differentiation specificity was 81.8%,81.8% and 91.9%,respectively.Conclusion The CBF,CBV and PS values of multi-slice CTP show high sensitivity and specificity in differentiating the diagnosis of high-and low-grade astroeytic tumors.