摘要
目的评价CT灌注参数与非小细胞肺癌（NSCLC）早期疗效及预后的关系，以期对患者的个体化治疗和个体化预后评估发挥一定的作用。方法对152例拟诊肺癌的患者行前瞻性MSCT灌注扫描，采用非离子型对比剂50ml，注射流率4．0ml／s，延迟10s，扫描时间50S。152例中123例病理证实为肺癌。评价CT灌注图像质量，对接受化疗、放疗或同步放化疗的患者进行早期疗效评估。采用t检验和Kaplan—Meier生存分析，评价NSCLC灌注参数与化、放疗早期疗效及预后的关系。结果有病理证实且图像质量达到评价标准的NSCLC35例，缓解组（21例）和未缓解组（14例）的血流量（BF）分别为（81．0±33．6）和（56．3±23．1）ml·min^-1·100g^-1，差异有统计学意义（t=9．341，P=0．023）。血流量≤80与〉80ml·min^-1·100g^-1组比较，中位无进展生存期分别为11．8和8．0个月，差异无统计学意义（P〉0．05）。血容量≤6与〉6ml／100g。组比较，中位无进展生存期分别为9．2和8．0个月，差异无统计学意义（P〉0．05）。结论NSCLC的高灌注状态提示对化、放疗反应相对敏感，早期缓解率高，但肿瘤进展时间相对较短。
Objective To prospectively investigate whether any of the perfusion parameters would predict early tumor response to chemotherapy and/or radiotherapy and prognosis in non-small cell lung cancer （NSCLC）. Methods In a prospective series, Perfusion CT were performed in 152 patients suspected lung cancer with 16-slice or 8-slice multislice CT. Contrast medium （50 ml） was injected at a rate of 4 ml/s with a power injector. The scanning delay was 10 seconds and the scanning time was 50 seconds. Among 152 patients,123 patients were proved lung cancer by pathology. With the perfusion 3.0 software, the parameters including blood flow （BF）, blood volume （BV）, mean transit time （MTT） and capillary permeability surface area product （PS） were calculated. The perfusion image quality was evaluated on a 4-1eveal scale. The treatment response after chemotherapy and（or） radiotherapy was assessed with Response Evaluation Criteria in Solid Tumors （RECIST） ,and then the relationship between perfusion parameters with early tumor response to chemotherapy and（or） radiotherapy was evaluated. Student t test and Kaplan-Meier estimates were used for data analysis. Results In 84 patients （68. 3% ） , the perfusion image quality was staged level 2 （moderate） and level 3 （good）. Among them, 35 patients with NSCLC were assessed with RECIST after chemotherapy and （or） radiotherapy. In these 35 patients, The BF of responders and nonrcsponders was （81.0±33.6） and （56. 3 ±23.1 ） ml·min^-1·100g^-1, respectively, which was significantly different（ t = 2. 393, P = 0. 023 ）. The median PFS of low-BF group （ BF ≤ ml·min^-1·100g^-1） and high-BF group （ BF 〉 80 ml·min^-1·100g^-1 ） was 11.8 and 8.0 months respectively （P〉0. 05）, and the median PFS of low-BV group （BF ≤ 6 ml/100 g^-1） and high-BV group （ BF 〉 6 ml/100g^-1 ） was 9. 2 and 8.0 months respectively （P 〉 0. 05 ）, both of them were not significantly different. Conclusion NSCLC in high perfusion are relatively sensitive to chemotherapy and/or radiotherapy, and the response rate is relatively higher, but the progress time is relatively shorter.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2010年第1期12-15,共4页
Chinese Journal of Radiology
关键词
癌
非小细胞肺
体层摄影术
X线计算机
灌流
预后
Carcinoma, non-small-cell lung
Tomography, X-ray computed
Perfusion
Prognosis
