中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2010年
7期
126-128
,共3页
相成%丰长申%徐锐%朱甲峰
相成%豐長申%徐銳%硃甲峰
상성%봉장신%서예%주갑봉
体层摄影术%X线计算机%灌注成像%肾肿瘤
體層攝影術%X線計算機%灌註成像%腎腫瘤
체층섭영술%X선계산궤%관주성상%신종류
Tomography,X-ray computed%Perfusion imaging%Renal neoplasms
目的 运用多层螺旋CT(MSCT)获取肾癌灌注图像,并与其分子病理学特征相对照,探讨MSCT灌注成像在肾癌诊断和鉴别诊断中的临床应用价值.方法 对42例疑有肾肿瘤的患者行MSC灌注扫描,获得伪彩色的血流灌注参数图,包括血流量(BF)、血容量(BV)、表面通透性(PS)及平均通过时间(MTT)图.在瘤体及瘤旁正常肾皮质选取感兴趣区并记录相应的各项参数值.所有患者均经手术病理证实.采用免疫组化方法(SP法)检测肾肿瘤中血管内皮生长因子(VEGF)的表达及微血管密度(MVD).结果 肾细胞癌的BF、BV和PS值均明显低于正常肾皮质,且Ⅲ级肾癌与Ⅰ、Ⅱ级相比,其BF、BV和PS值明显增高.肾癌的BF、BV、PS值与其VEGF平均光密度值呈正相关(P＜0.05),MTT值与VEGF平均光密度值呈负相关(P＜0.05).肾癌的MVD值与VEGF值呈正相关(P＜0.05).结论 MSCT灌注成像能定量评价肿瘤血管生成、血流灌注及血管通透性改变,有助于肾细胞癌的术前分级,并在肾癌的定性诊断和鉴别诊断方面有一定临床应用价值.
目的 運用多層螺鏇CT(MSCT)穫取腎癌灌註圖像,併與其分子病理學特徵相對照,探討MSCT灌註成像在腎癌診斷和鑒彆診斷中的臨床應用價值.方法 對42例疑有腎腫瘤的患者行MSC灌註掃描,穫得偽綵色的血流灌註參數圖,包括血流量(BF)、血容量(BV)、錶麵通透性(PS)及平均通過時間(MTT)圖.在瘤體及瘤徬正常腎皮質選取感興趣區併記錄相應的各項參數值.所有患者均經手術病理證實.採用免疫組化方法(SP法)檢測腎腫瘤中血管內皮生長因子(VEGF)的錶達及微血管密度(MVD).結果 腎細胞癌的BF、BV和PS值均明顯低于正常腎皮質,且Ⅲ級腎癌與Ⅰ、Ⅱ級相比,其BF、BV和PS值明顯增高.腎癌的BF、BV、PS值與其VEGF平均光密度值呈正相關(P＜0.05),MTT值與VEGF平均光密度值呈負相關(P＜0.05).腎癌的MVD值與VEGF值呈正相關(P＜0.05).結論 MSCT灌註成像能定量評價腫瘤血管生成、血流灌註及血管通透性改變,有助于腎細胞癌的術前分級,併在腎癌的定性診斷和鑒彆診斷方麵有一定臨床應用價值.
목적 운용다층라선CT(MSCT)획취신암관주도상,병여기분자병이학특정상대조,탐토MSCT관주성상재신암진단화감별진단중적림상응용개치.방법 대42례의유신종류적환자행MSC관주소묘,획득위채색적혈류관주삼수도,포괄혈류량(BF)、혈용량(BV)、표면통투성(PS)급평균통과시간(MTT)도.재류체급류방정상신피질선취감흥취구병기록상응적각항삼수치.소유환자균경수술병리증실.채용면역조화방법(SP법)검측신종류중혈관내피생장인자(VEGF)적표체급미혈관밀도(MVD).결과 신세포암적BF、BV화PS치균명현저우정상신피질,차Ⅲ급신암여Ⅰ、Ⅱ급상비,기BF、BV화PS치명현증고.신암적BF、BV、PS치여기VEGF평균광밀도치정정상관(P＜0.05),MTT치여VEGF평균광밀도치정부상관(P＜0.05).신암적MVD치여VEGF치정정상관(P＜0.05).결론 MSCT관주성상능정량평개종류혈관생성、혈류관주급혈관통투성개변,유조우신세포암적술전분급,병재신암적정성진단화감별진단방면유일정림상응용개치.
Objective To study the correlation of the perfusion CT parameters and the molecular pathology characteristics of the renal cell carcinoma( RCC ),and to discuss the value of multi-slice CT(MSCT) perfusion imaging in the diagnosis and differential diagnosis of RCC.Methods 42 patients with clinically suspected renal tumors underwent MSCT perfusion imaging.The maps of renal blood volume (BV),blood flow (BF),permeability surface (PS)and mean transit time (MTT)were obtained.Regions of interest (ROI)were drawn within the tumor and the region of normal area adjacent to the tumor.All of the tumors were proved by surgery and pathology withRCC ( n = 42 ).Vascular endothelial growth factor (VEGF) expression and micro-vascular density (MVD) were measured with immuno-histology chemistry technique( SP technique).Results Of the 42RCC,the mean BF,BV and PS value were obviously lower than that of normal renal cortex;moreover,the above-mentioned parameters in grade Ⅲweresignificantly higher than that of grade Ⅰ and Ⅱ RCC.A significant inverse correlation (P ＜ 0.05 )was observed between the mean MTT value and the VEGF expression.The mean BF,BV and PS of RCC had a significant positive correlation with VEGF expression(P ＜ 0.05 ).Conclusion Tumor angiogenesis,blood flow perfusion and permeability surface could be quantitatively evaluated by MSCT perfusion imaging.It provides useful information for pre-surgical staging of RCC and benefit s the clinical diagnosis and differential diagnosis of RCC.
