本文關(guān)鍵詞： 胰腺腫瘤 微循環(huán) 動(dòng)態(tài)容積CT 灌注成像　出處：《大連醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討640層動(dòng)態(tài)容積CT全胰腺低劑量灌注成像技術(shù)的應(yīng)用價(jià)值，應(yīng)用該技術(shù)分析不同胰腺疾病的灌注差異，對(duì)胰腺癌早期微循環(huán)的改變做出判斷，為胰腺癌的早期診斷及鑒別診斷提供依據(jù)。 材料與方法：對(duì)21例擬診胰腺疾病患者和9例健康志愿者（男性26例，女性4例，年齡24歲-73歲，平均年齡51歲）行胰腺全器官低劑量CT灌注成像檢查。根據(jù)患者身體重量指數(shù)（Body Mass Index）以6-8ml/s的注射速度使用雙筒高壓注射器經(jīng)右肘靜脈順序團(tuán)注優(yōu)維顯30-40m（l370mg iodine/ml）與生理鹽水30ml，同步應(yīng)用東芝640層容積CT（Aquilin-ONE）進(jìn)行胰腺全器官CT灌注掃描。對(duì)采集的容積數(shù)據(jù)進(jìn)行對(duì)位處理和灌注分析，采用最大斜率法獲取感興趣區(qū)的時(shí)間-密度曲線、血流灌注圖、組織血流量等灌注參數(shù)。應(yīng)用SPSS13.0軟件進(jìn)行統(tǒng)計(jì)分析。 結(jié)果：所有受試者均完成全胰腺低劑量CT灌注成像檢查。其中包括胰腺癌11例；急性胰腺炎6例，其中伴有胰頭壞死1例；4例慢性胰腺炎中1例伴有胰腺假囊腫形成；正常胰腺9例。正常胰腺組織動(dòng)脈血流量為117.04±12.05ml/min/100ml，胰腺炎組織動(dòng)脈血流量為118.67±37.18ml/min/100ml，，胰腺癌組織動(dòng)脈血流量為67.16±18.94ml/min/100ml(F=8.59, p=0.0004)。胰腺癌組與正常胰腺組及胰腺炎組有明顯統(tǒng)計(jì)學(xué)差異(p0.05)，且血流灌注圖中可以明確顯示該差異；正常胰腺組與胰腺炎組之間無明顯統(tǒng)計(jì)學(xué)差異(p0.05)。X射線的總劑量約為21.5-23.9mSv。 結(jié)論：在對(duì)患者進(jìn)行細(xì)致地檢查前準(zhǔn)備和充分地呼吸訓(xùn)練基礎(chǔ)上，配合合理的對(duì)比劑濃度、劑量及團(tuán)注速度、掃描參數(shù)和后處理方法等，胰腺全器官低劑量CT灌注成像可取得良好的檢查結(jié)果及灌注數(shù)據(jù)，并能有效評(píng)價(jià)胰腺疾病的血流動(dòng)力學(xué)改變，對(duì)胰腺癌的早期診斷及鑒別診斷有重要潛在價(jià)值。
[Abstract]:Objective: to evaluate the application value of 640slice dynamic volume CT low-dose perfusion imaging of whole pancreas, analyze the difference of perfusion in different pancreatic diseases, and judge the changes of microcirculation in early stage of pancreatic cancer. To provide evidence for early diagnosis and differential diagnosis of pancreatic cancer. Materials and methods: 21 patients with pancreatic diseases and 9 healthy volunteers (male 26, female 4, aged 24 to 73 years) were studied. Low dose CT perfusion imaging of the whole pancreas. Body Mass index based on body mass index (BMI). The injection rate of 6-8 ml / s was injected with a double-tube high-pressure syringe through the right elbow vein in a sequential group of 30-40mL ~ 370mg iodine / ml and 30ml saline. The CT perfusion scanning of the whole pancreas was performed with Toshiba 640 slice volume CTAquilin-ONE.The volume data were processed and perfused. The time-density curve, perfusion graph and tissue blood flow of the region of interest were obtained by the maximum slope method. The statistical analysis was carried out with SPSS13.0 software. Results: all subjects completed low-dose CT perfusion imaging of the whole pancreas, including 11 cases of pancreatic cancer. There were 6 cases of acute pancreatitis, including 1 case with pancreatic head necrosis. Among 4 cases of chronic pancreatitis, 1 case was accompanied by pancreatic pseudocyst formation. The arterial blood flow of normal pancreas was 117.04 鹵12.05 ml / min / 100 ml. The arterial blood flow was 118.67 鹵37.18ml / min / 100ml. The arterial blood flow of pancreatic carcinoma was 67.16 鹵18.94 ml / min / 100 ml / min / 100 ml / min respectively. There was significant difference between pancreatic cancer group and normal pancreas group and pancreatitis group. There was no significant difference between normal pancreas group and pancreatitis group. The total dose of X ray was about 21.5-23.9mSv. Conclusion: on the basis of careful preparation before examination and adequate breathing training, reasonable contrast agent concentration, dose and mass injection rate, scanning parameters and post-treatment methods were used. Low-dose CT perfusion imaging of pancreatic organs can obtain good results and perfusion data, and can effectively evaluate the hemodynamic changes of pancreatic diseases. It has important potential value in early diagnosis and differential diagnosis of pancreatic cancer.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R816.6;R735.9

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