CAJ | 학술논문

目的探讨卵巢肿瘤多层螺旋CT灌注成像参数与微血管密度计数(MVD)间的相关性,从解剖和功能上了解卵巢肿瘤的血流动力学特点.方法选取已行多层螺旋CT灌注成像并有手术病理证实的卵巢良、恶性肿瘤各6例.采用菲利浦公司生产的16层螺旋CT进行灌注成像,采集时间密度曲线及灌注值、强化峰值(PEI)、达峰进间(TTP)、血容量(BV).所选病例术后病理标本采用EnVision~(TM)二步法对肿瘤微血管进行免疫组织化学染色检测肿瘤内的MVD.结果卵巢良性肿瘤的时间密度曲线上升较缓慢,在40 S时达到峰值;而恶性肿瘤则呈持续快速上升.25 s时接近峰值.卵巢肿瘤的灌注参数PEI、TTP、BV在良、恶性之间存在显著性差异(P<0.05);MVD计数显示卵巢恶性肿瘤的微血管密度大于良性肿瘤(P<0.05);CT灌注参数BV值与肿瘤内MVD存在正相关性(r=0.786.P<0.05).结论 CT灌注成像可精确反映病变在各个时间点的强化特点,通过揭示病变内部血流动力学改变,有助于卵巢良、恶性肿瘤的诊断与鉴别诊断.
목적 탐토란소종류다층라선CT관주성상삼수여미혈관밀도계수(MVD)간적상관성,종해부화공능상료해란소종류적혈류동역학특점.방법 선취이행다층라선CT관주성상병유수술병리증실적란소량、악성종류각6례.채용비리포공사생산적16층라선CT진행관주성상,채집시간밀도곡선급관주치、강화봉치(PEI)、체봉진간(TTP)、혈용량(BV).소선병례술후병리표본채용EnVision~(TM)이보법대종류미혈관진행면역조직화학염색검측종류내적MVD.결과 란소량성종류적시간밀도곡선상승교완만,재40 S시체도봉치;이악성종류칙정지속쾌속상승.25 s시접근봉치.란소종류적관주삼수PEI、TTP、BV재량、악성지간존재현저성차이(P<0.05);MVD계수현시란소악성종류적미혈관밀도대우량성종류(P<0.05);CT관주삼수BV치여종류내MVD존재정상관성(r=0.786.P<0.05).결론 CT관주성상가정학반영병변재각개시간점적강화특점,통과게시병변내부혈류동역학개변,유조우란소량、악성종류적진단여감별진단.
Objective To analyze the correlation between pthe erfusion data and microvessel density (MVD) in ovarian tumors, and investigate the hemodynamic features of the tumors in terms of anatomy and functional CT imaging. Methods Six patients with surgically confirmed benign ovarian tumors and 6 with malignant ovarian tumors underwent multi-slice CT perfusion imaging to acquire the perfusion parameters including perfusion, PEI, TTP, BV peak enhancement image(PEI), time to peak (TTP) and blood volume (BV). The tumors were stained and counted by Immunohistochemical staining of the microvessels in the tumor was performed to detect the MVD. Results The time-density curves of the benign ovarian tumors increased slowly, reaching the peak at 40 s; the curves of the malignant tumors rose rapidly and continuously and reached the peak at 25 s. The differences in the perfusion data (PEI, TTP, BV) were statistically significant between the benign and malignant tumors (P<0.05). The MVD of the malignant tumors was significantly greater than that of the benign rumors (P<0.05). The mean BV of the malignant ovarian tumor was positively correlated to MVD (r=0.786, P<0.05). Conclusion Multi-slice spiral CT perfusion imaging can provide accurate enhancement data of the ovarian tumors and helps in the diagnosis and differential diagnosis of the ovarian tumors by presenting the changes of the hemodynamic features in the tumors.