CAJ | 학술논문

目的应用低剂量全器官动态容积CT对胰腺组织进行灌注成像,并分析不同疾病的灌注差异，为全器官CT灌注成像的临床应用提供依据。资料与方法采用640层容积CT对28例拟诊为胰腺疾病的患者行胰腺CT灌注成像。在团注对比剂时同步采集数据，应用灌注软件对所得容积数据进行空间对位配准及灌注分析，采用最大斜率法获取感兴趣区的时间-密度曲线、血流灌注图、组织动脉血流量等。结果28例患者中，胰腺癌10例；急性胰腺炎6例，其中1例伴胰头坏死灶形成；慢性胰腺炎3例，其中1例伴假囊肿形成；正常胰腺9例。正常胰腺组织动脉血流量为（117.04±12.05）ml/（min?100 ml），胰腺炎症组织为（118.67±37.18）ml/（min?100 ml），胰腺癌组织为（67.16±18.94）ml/（min?100 ml），三组差异有统计学意义（F=8.59, P<0.001）；胰腺癌组与正常胰腺组及胰腺炎组间差异有统计学意义（q=3.70, P<0.05），且血流灌注图中可以明确显示该差异；正常胰腺组与胰腺炎组间差异无统计学意义（q=2.91, P>0.05）。扫描全过程X线总剂量为21.5~23.9 mSv。结论低剂量胰腺全器官CT灌注扫描可以定量分析胰腺疾病的血流动力学改变，对评价胰腺癌诊疗过程中微循环的改变具有重要价值。
목적응용저제량전기관동태용적CT대이선조직진행관주성상,병분석불동질병적관주차이，위전기관CT관주성상적림상응용제공의거。자료여방법채용640층용적CT대28례의진위이선질병적환자행이선CT관주성상。재단주대비제시동보채집수거，응용관주연건대소득용적수거진행공간대위배준급관주분석，채용최대사솔법획취감흥취구적시간-밀도곡선、혈류관주도、조직동맥혈류량등。결과28례환자중，이선암10례；급성이선염6례，기중1례반이두배사조형성；만성이선염3례，기중1례반가낭종형성；정상이선9례。정상이선조직동맥혈류량위（117.04±12.05）ml/（min?100 ml），이선염증조직위（118.67±37.18）ml/（min?100 ml），이선암조직위（67.16±18.94）ml/（min?100 ml），삼조차이유통계학의의（F=8.59, P<0.001）；이선암조여정상이선조급이선염조간차이유통계학의의（q=3.70, P<0.05），차혈류관주도중가이명학현시해차이；정상이선조여이선염조간차이무통계학의의（q=2.91, P>0.05）。소묘전과정X선총제량위21.5~23.9 mSv。결론저제량이선전기관CT관주소묘가이정량분석이선질병적혈류동역학개변，대평개이선암진료과정중미순배적개변구유중요개치。
Purpose To analyze the perfusion differences of different pancreatic diseases using the low-dose whole organ dynamic volume CT perfusion imaging, and to provide the evidence for the clinical application. Materials and Methods Twenty-eight patients suspected as pancreatic disease were applied by 640 layer volume CT perfusion imaging for the pancreas. Data were collected at the same time of bolus injection of contrast agent, then were analyzed by spatial alignment and perfusion calculation using the perfusion software. The time-density curve, blood perfusion flow diagram and tissue artery blood flow were obtained using the maximum slope method. Results Normal pancreatic tissue (n=9) blood flow was (117.04±12.05) ml/(min?100 ml), pancreatitis organizations (6 cases with acute pancreatitis and 3 cases with chronic pancreatitis) (118.67±37.18) ml/(min?100 ml), pancreatic carcinoma tissue (n=10) was (67.16±18.94) ml/(min?100 ml). There was significant difference among three groups (F=8.59, P<0.001);the difference was demonstrated in pancreatic cancer vs. normal pancreas and pancreatic cancer vs. pancreatitis group (q=3.70, P<0.05), which could be clearly demonstrated by blood perfusion flow diagram. The difference was not statistically revealed pancreatitis and normal pancreas group (q=2.91, P>0.05). The total dose of X-rays in the whole scanning process was 21.5-23.9 mSv. Conclusion Low-dose whole pancreas organ CT perfusion scan can quantitatively analyze the hemodynamic changes in pancreatic disease, which be of great value for evaluating changes in microcirculation during the treatment of pancreatic cancer.