放射性肺炎CT灌注成像的临床研究

Application of CT perfusion imaging in radiation pneumonitis

  • 摘要: 目的 采用CT灌注成像(CTPI)技术,探求放射性肺炎(RP)形成的CTPI特点,为预测RP提供依据。方法 对37例胸部肿瘤患者照射前后不同时期行64排螺旋CT灌注成像扫描,得到肺组织感兴趣区(ROI)内各灌注参数值,即血流量(BF)、血容量(BV)、峰值时间(TTP)、表面通透性(PS)、平均通过时间(MTT),进而计算出各灌注参数相对值(rBF、rBV、rTTP、rPS、rMTT)。结果 放疗前,肺癌及其他胸部肿瘤患者的非瘤周肺组织灌注值BF、BV、TTP及MTT均无差异,与性别无关(t值分别为0.643、1.541、0.470及1.199,P>0.05),与左右肺也无关(t值分别为0.857、0.346、0.470及1.656,P>0.05);放疗后,rBF、rBV、rPS均上升者(F值分别为5.552、8.495及14.951,P均<0.05)将发生RP,仅rBF上升者(F=9.146,P<0.05)不发生RP。结论 CTPI可用于肺组织灌注的研究,能反映照射后肺组织灌注的变化规律;rBF、rBV、rPS是预测RP的关键参数。

     

    Abstract: Objective To investigate the relation between the change of perfusion parameter values and the formation of radiation pneumonitis (RP), with the technique of CT perfusion imaging (CTPI).Methods Sixty-four slices spiral CTPI were performed in 37 patients with thoracic tumor before and after irradiation with different doses in different phases.And varied perfusion parameters of region of interest (ROI) in lung tissue were assessed such as blood flow (BF), blood volume(BV), time to peak(TIP), permeability surface(PS), mean transit time (MTF) and relative values of these parameters were calculated, i.e, rBF, rBV, rTIP, rPS, rMTT.Results The perfusion parameters of non-tumor peripheral lung tissue before irradiation had no difference among lung or non-lung cancer and different gender as well.RP occurred in the cases with the remarkable boost in rBF, rBV and rPS (the value of F was 5.552,8.495 and 14.951 respectively, P<0.05), while RP would not happen if rBF significantly ascended only(F=9.146, P<0.05).Conclusion s The rule of perfusion change of lung tissue after irradiation could be detected with CTPI and it had been demonstrated that the application of CTPI in studying lung perfusion and RP was valuable.The parameters such as rBF, rBV and rPS had an important role in forecasting RP.

     

/

返回文章
返回