CAJ | 학술논문

目的探讨256层螺旋CT肺癌灌注成像中不同ROI选择方法对测量结果准确性的影响.方法对27例经临床确诊为肺癌的患者行肺CT灌注扫描.将所得图像传人工作站做后处理,ROI的选择采用60、120 mm2和最大层面全肿瘤大小3种方式,分别获得中心区和边缘区的灌注值、血容量和强化峰值等灌注参数,并与其中19例手术患者微血管密度(MVD)进行相关分析,以配对t检验对所获得的各种灌注参数值进行比较.结果在60和120 mm2的ROI,边缘区所测得灌注值(M=15.40、9.50 ml.min-1·100 ml- 1)、血容量(M=35.60、25.40 ml·100 g-1)及强化峰值(M=16.47、10.20 HU)均高于中心区灌注值(M=14.80、8.52 ml· min-1·100 ml-1)、血容量(M =33.50、23.90 ml·100 g-1)及强化峰值(M=15.64、9.40 HU),差异有统计学意义(t值分别为10.95、9.80、7.06、2.93、7.74和10.09,P值均＜0.05)；包括全肿瘤大小的ROI所测灌注值(M=12.51 ml·min-1·100 ml-1)、血容量(M=29.31 ml.100 g-1)及强化峰值(M=12.93 HU)介于上述两者之间.包括全肿瘤大小的ROI所测灌注值、血容量及强化峰值与MVD[( 19.43±8.78)条/0.74 mm2]相关性最好(r值分别为0.732、0.590和0.544,P值均＜0.05).结论 ROI的位置和大小均影响灌注参数值；以最大层面全肿瘤区域法划定ROI,可获得比随机勾画ROI准确性更高的数据.
목적 탐토256층라선CT폐암관주성상중불동ROI선택방법대측량결과준학성적영향.방법 대27례경림상학진위폐암적환자행폐CT관주소묘.장소득도상전인공작참주후처리,ROI적선택채용60、120 mm2화최대층면전종류대소3충방식,분별획득중심구화변연구적관주치、혈용량화강화봉치등관주삼수,병여기중19례수술환자미혈관밀도(MVD)진행상관분석,이배대t검험대소획득적각충관주삼수치진행비교.결과 재60화120 mm2적ROI,변연구소측득관주치(M=15.40、9.50 ml.min-1·100 ml- 1)、혈용량(M=35.60、25.40 ml·100 g-1)급강화봉치(M=16.47、10.20 HU)균고우중심구관주치(M=14.80、8.52 ml· min-1·100 ml-1)、혈용량(M =33.50、23.90 ml·100 g-1)급강화봉치(M=15.64、9.40 HU),차이유통계학의의(t치분별위10.95、9.80、7.06、2.93、7.74화10.09,P치균＜0.05)；포괄전종류대소적ROI소측관주치(M=12.51 ml·min-1·100 ml-1)、혈용량(M=29.31 ml.100 g-1)급강화봉치(M=12.93 HU)개우상술량자지간.포괄전종류대소적ROI소측관주치、혈용량급강화봉치여MVD[( 19.43±8.78)조/0.74 mm2]상관성최호(r치분별위0.732、0.590화0.544,P치균＜0.05).결론 ROI적위치화대소균영향관주삼수치；이최대층면전종류구역법화정ROI,가획득비수궤구화ROI준학성경고적수거.
Objective To prospectively determine whether position and size of tumor region of interest (ROI) influence estimates of lung cancer vascular parameters at 256-slice CT perfusion study.Methods After institutional review board approval and informed consent,16 men and 11 women with lung cancer underwent 70-second CT perfusion study. Perfusion, blood volume, peak enhancement weredetermined for 60 or 120 mm2 circular ROIs placed at the tumor edge and center and around (outlining) visible tumor. ROI analysis was repeated twice by two observers in the same way to get the average values.The correlation between the measurements and microvascular density counts was determined in 19 patients with operation.Measurements were compared by using Pair-Samples t test,a difference with P≤0.05 was significant.Results Perfusion,blood volume,peak enhancement measurements were substantially higher at the edge than at the center for both 60 and 120 mm2 ROI. For 60 and 120 mm2 ROI,median of the three measurements were (M=15.40,9.50 ml · min- 1 · 100 ml - 1,M =35.60,25.40 ml · 100 g-1,and M=16.47,10.20 HU),respectively,at the edge versus(M =14.80,8.52 ml · min- 1 · 100 ml- 1,M =33.50,23.90 ml · 100 g- 1,and M =15.64,9.40 HU),respectively,at the center(t value was 10.95,9.80,7.06,2.93,7.74 and 10.09,respectively,all P ＜ 0.05 ). Measurements varied substantially depending on the ROI size,values for the ROI for outlined tumor were intermediate between those at the tumor edge and center.Perfusion(M=12.51 ml.min- 1 · 100 ml-1),blood volume(M=29.31 ml.100 g-1),peakenhancement (M =12.93 HU) for the ROI outlining tumor were intermediate between those at the tumor edge and center.There was a good correlation between perfusion,blood volume,peak enhancement for the ROI outlining tumor and microvascular density[ ( 19.43 ± 8.78 ) vessels/0.74 mm2 ],respectively ( r value 0.732,0.590 and 0.544,all P ＜ 0.05 ).Conclusions Position and size of tumor ROI substantially influence ultimate perfusion values.ROI for outlined entire tumor is more reliable for perfusion measurements and more appropriate clinically than use of arbitrarily determined smaller ROI.