中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2014年
2期
124-127
,共4页
孙宏亮%徐妍妍%胡莹莹%田元江%王武
孫宏亮%徐妍妍%鬍瑩瑩%田元江%王武
손굉량%서연연%호형형%전원강%왕무
结直肠肿瘤%体层摄影术,X线计算机
結直腸腫瘤%體層攝影術,X線計算機
결직장종류%체층섭영술,X선계산궤
Colorectal neoplasms%Tomography,X-ray computed
目的 探讨结直肠癌CT全肿瘤与肿瘤最大层面灌注成像灌注参数的一致性及测量的可重复性.方法 收集22例经病理证实的结直肠腺癌患者行256层螺旋CT灌注成像检查,获得全肿瘤灌注图像,2名医师分别测量记录每个肿瘤最大层面以及每个肿瘤所有层面各项灌注参数值的均值,其中1名医师间隔3个月后重复上述测量.测量的参数值包括血流量(BF)、血容量(BV)及达峰时间(TTP).采用配对t检验比较2种分析方法所得灌注参数的差异,采用Bland-Altman检验评估相同观察者及不同观察者重复测量的一致性.结果 22例患者顺利完成检查.采用全肿瘤多层面方法得到的BF、BV及TTP分别为(35.59±14.59)ml·min-1·100g-1、(17.55 ±4.21)ml·100 g-1和(21.30 ±7.57)s,采用肿瘤最大层面方法得到的上述值分别为(34.64±13.29)ml·min-1·100g-1、(17.61 ±6.39)ml·100 g-1和(19.82 ±9.01)s,差异均无统计学意义(t值分别为0.218、-0.033和-0.668,P值均＞0.05).同一医师前后2次采用全肿瘤多层面方法,所得BF、BV、TTP差异度的95％一致性范围分别为(-5.3 ～10.0)％、(-13.8～10.8)％和(-15.0～12.6)％,采用肿瘤最大层面方法,所得BF、BV、TTP结果95％一致性范围分别为(-14.3 ～ 16.5)％、(-24.2 ～ 22.2)％和(-19.0～16.1)％；2名医师采用全肿瘤多层面灌注分析方法,所得BF、BV、TTP差异度的95％一致性范围分别为(-8.0～8.3)％、(-10.9～11.5)％和(-14.5～11.1)％,采用肿瘤最大层面灌注分析方法,所得上述结果的95％一致性范围分别为(-10.2～14.1)％、(-19.0～17.6)％和(-22.0 ～24.0)％,说明采用全肿瘤灌注分析方法重复性更好.结论 肿瘤最大层面与全肿瘤多层面平均灌注分析方法所得灌注结果差异无统计学意义,但后者对灌注参数测量的可重复性更高,更能反映肿瘤整体的血管生成情况.
目的 探討結直腸癌CT全腫瘤與腫瘤最大層麵灌註成像灌註參數的一緻性及測量的可重複性.方法 收集22例經病理證實的結直腸腺癌患者行256層螺鏇CT灌註成像檢查,穫得全腫瘤灌註圖像,2名醫師分彆測量記錄每箇腫瘤最大層麵以及每箇腫瘤所有層麵各項灌註參數值的均值,其中1名醫師間隔3箇月後重複上述測量.測量的參數值包括血流量(BF)、血容量(BV)及達峰時間(TTP).採用配對t檢驗比較2種分析方法所得灌註參數的差異,採用Bland-Altman檢驗評估相同觀察者及不同觀察者重複測量的一緻性.結果 22例患者順利完成檢查.採用全腫瘤多層麵方法得到的BF、BV及TTP分彆為(35.59±14.59)ml·min-1·100g-1、(17.55 ±4.21)ml·100 g-1和(21.30 ±7.57)s,採用腫瘤最大層麵方法得到的上述值分彆為(34.64±13.29)ml·min-1·100g-1、(17.61 ±6.39)ml·100 g-1和(19.82 ±9.01)s,差異均無統計學意義(t值分彆為0.218、-0.033和-0.668,P值均＞0.05).同一醫師前後2次採用全腫瘤多層麵方法,所得BF、BV、TTP差異度的95％一緻性範圍分彆為(-5.3 ～10.0)％、(-13.8～10.8)％和(-15.0～12.6)％,採用腫瘤最大層麵方法,所得BF、BV、TTP結果95％一緻性範圍分彆為(-14.3 ～ 16.5)％、(-24.2 ～ 22.2)％和(-19.0～16.1)％；2名醫師採用全腫瘤多層麵灌註分析方法,所得BF、BV、TTP差異度的95％一緻性範圍分彆為(-8.0～8.3)％、(-10.9～11.5)％和(-14.5～11.1)％,採用腫瘤最大層麵灌註分析方法,所得上述結果的95％一緻性範圍分彆為(-10.2～14.1)％、(-19.0～17.6)％和(-22.0 ～24.0)％,說明採用全腫瘤灌註分析方法重複性更好.結論 腫瘤最大層麵與全腫瘤多層麵平均灌註分析方法所得灌註結果差異無統計學意義,但後者對灌註參數測量的可重複性更高,更能反映腫瘤整體的血管生成情況.
목적 탐토결직장암CT전종류여종류최대층면관주성상관주삼수적일치성급측량적가중복성.방법 수집22례경병리증실적결직장선암환자행256층라선CT관주성상검사,획득전종류관주도상,2명의사분별측량기록매개종류최대층면이급매개종류소유층면각항관주삼수치적균치,기중1명의사간격3개월후중복상술측량.측량적삼수치포괄혈류량(BF)、혈용량(BV)급체봉시간(TTP).채용배대t검험비교2충분석방법소득관주삼수적차이,채용Bland-Altman검험평고상동관찰자급불동관찰자중복측량적일치성.결과 22례환자순리완성검사.채용전종류다층면방법득도적BF、BV급TTP분별위(35.59±14.59)ml·min-1·100g-1、(17.55 ±4.21)ml·100 g-1화(21.30 ±7.57)s,채용종류최대층면방법득도적상술치분별위(34.64±13.29)ml·min-1·100g-1、(17.61 ±6.39)ml·100 g-1화(19.82 ±9.01)s,차이균무통계학의의(t치분별위0.218、-0.033화-0.668,P치균＞0.05).동일의사전후2차채용전종류다층면방법,소득BF、BV、TTP차이도적95％일치성범위분별위(-5.3 ～10.0)％、(-13.8～10.8)％화(-15.0～12.6)％,채용종류최대층면방법,소득BF、BV、TTP결과95％일치성범위분별위(-14.3 ～ 16.5)％、(-24.2 ～ 22.2)％화(-19.0～16.1)％；2명의사채용전종류다층면관주분석방법,소득BF、BV、TTP차이도적95％일치성범위분별위(-8.0～8.3)％、(-10.9～11.5)％화(-14.5～11.1)％,채용종류최대층면관주분석방법,소득상술결과적95％일치성범위분별위(-10.2～14.1)％、(-19.0～17.6)％화(-22.0 ～24.0)％,설명채용전종류관주분석방법중복성경호.결론 종류최대층면여전종류다층면평균관주분석방법소득관주결과차이무통계학의의,단후자대관주삼수측량적가중복성경고,경능반영종류정체적혈관생성정황.
Objective To determine the consistency between quantitative CT perfusion measurements of colorectal cancer obtained from single section with maximal tumor dimension and from average of whole tumor,and compare intra-and inter-observer consistency of the two analysis methods.Methods Twenty-two patients with histologically proven colorectal cancer were examined prospectively with 256-slice CT and the whole tumor perfusion images were obtained.Perfusion parameters were obtained from region of interest (ROI) inserted in single section showing maximal tumor dimension,then from ROI inserted in all tumor-containing sections by two radiologists.Consistency between values of blood flow (BF),blood volume (BV) and time to peak (TTP) calculated by two methods was assessed.Intra-observer consistency was evaluated by comparing repeated measurements done by the same radiologist using both methods after 3 months.Perfusion measurements were done by another radiologist independently to assess inter-observer consistency of both methods.The results from different methods were compared using paired t test and Bland-Altmnan plot.Results Twenty-two patients were examined successfully.The perfusion parameters BF,BV and TTP obtained by whole tumor perfusion and single-section analysis were (35.59 ± 14.59) ml · min-1 · 100 g-1,(17.55 ±4.21) ml · 100 g-1,(21.30 ±7.57) s and (34.64 ± 13.29)ml· min-1 · 100 g-1,(17.61 ±6.39)ml± · 100 g-1,(19.82 ±9.01)s,respectively.No significant differences were observed between the means of the perfusion parameters (BF,BV,TTP)calculated by the two methods (t =0.218,-0.033,-0.668,P ＞ 0.05,respectively).The intra-observer 95％ limits of consistency of perfusion parameters were BF-5.3％ to 10.0％,BV-13.8％ to 10.8％,TTP-15.0％ to 12.6％ with whole tumor analysis,respectively; BF-14.3％ to 16.5％,BV-24.2％ to 22.2％,TTP-19.0％ to 16.1％ with single section analysis,respectively.The inter-observer 95％ limits of consistency of perfusion parameters were BF-8.0％ to 8.3％,BV-10.9％ to 11.5％,TTP -14.5％ to 11.1％ with whole volume analysis,respectively; BF-10.2％ to 14.1％,BV-19.0％ to 17.6％,TTP-22.0％ to 24.0％ with single section analysis,respectively.Conclusion There was no statistically different between the single section and whole volume analysis of tumor perfusion CT.The whole volume perfusion analysis apparently improves intra-and inter-observer consistency and can reflect the whole tumor angiogenesis more accurately and repeatedly.
