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多层螺旋CT灌注成像在脑肿瘤中的应用研究

作者:鞠发军, 闫培华, 唐公杰, 蔡自强
【关键词】  多层螺旋CT;,,脑灌注成像;,,脑肿瘤
  摘要:目的:探讨多层螺旋CT灌注成像在脑肿瘤中的应用价值。方法:应用GE lightspeedl6层螺旋CT扫描机,对经证实的20例脑瘤患者(脑膜瘤9例,胶质瘤7例,胶质瘤术后复发4例),先行CT平扫,选定感兴趣区行多层螺旋CT脑灌注成像,经灌注软件处理,计算出局部血容量图trCBV)、局部血流量医(rCBF)、表面通透性(PS),并与对侧相应脑组织灌注参数进行比较。所有病例均经CT随访或经MRI证实。部分病例联合CT增强扫描。结果:脑膜瘤、星形细胞瘤和胶质瘤术后复发三者中rCBV、rCBF、PS值均高于正常脑组织,其中脑膜瘤最高,高级别星形细胞瘤高于低级别星形细胞瘤。肿瘤的rCBV、rCBF、PS值与肿瘤的MVD呈正相关。结论:多层螺旋CT灌注成像能够在脑瘤的诊断、术前术后的随访中提供有价值的参考信息。
  关键词:  多层螺旋CT;  脑灌注成像;  脑肿瘤
  The Preliminary Research of MSCT Perfusion Imaging in Cerbral Neoplasmas
  Abstract: Objective: To discuss the clinical value of MSCT perfusion imge on the cerbral neoplasmas of glioma. Method: Using GE lightspeed 16spiral CT scanner, to carry out CT even sweep toward the 20 confirmed patients of acute cerbral neoplasmas (including meningiomas 9 cases astrocytoma 7 cases,glioma post-operrati on recurrent 4 cases) in advance. The color map of regiol cerebral blood volume(rCBV),region cerebral blood flow(rCBF) mid pcrmeability surfiace(PS) was obtained by perfusion software,and rCBV rCBF and PS were calaculated in different areas. Parts of cases consociation CT strengthens to scan. Result: The values of CBV rCBF anti PS of the three diseases meningiomas,astrocytoma, and glioma post-operration recmrent were higher than that of the brain organize. The meningiomas is the highest in the three. The values of rCBV rCBF and PS of the highe grade astrocytoma tumors were higher than that of lee grade astrocytoma tumors.There were positive linear correlation between the MVD and tumor rCBV rCBF and PS.Conclusion: MSCT perfusion imge can reflect the cerbral neoplasmas changes of blood flow. It may offer useful  information diagnosis,the frot-operation and post-opration follow-up of cerbral neoplasmas.

  Key words:  Mulit-slice spiral CT;  Cerebral perrinsion imaging;  Cerbral neoplasmas       
  随着多层螺旋CT的应用,计算方法的改进,可以进行多层同层灌注扫描,使以前主要应用于脑梗塞的诊断

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