本文選題：CT + 灌注成像��； 參考：《復旦大學》2013年碩士論文

【摘要】：通過全胰腺CT灌注成像測量正常胰腺和胰腺癌的CT灌注特征,探索全胰腺灌注成像在胰腺癌中的應用價值。并通過對胰腺癌病理標本MVD的檢查,探索胰腺癌CT灌注參數(shù)值和腫瘤血管生成的相關(guān)性。 第一部分正常胰腺組織的256層螺旋CT全器官灌注成像研究 目的：通過對無胰腺疾病患者的正常胰腺組織進行全器官CT灌注成像,獲得相關(guān)灌注參數(shù),探索正常胰腺的全器官灌注的特征。 材料和方法：2011年1月至2013年3月收集26例非胰腺疾病患者行全胰腺CT灌注。采用256層Philips Brilliance iCT,100kVp,100mAs,5mm層厚,350mm重建視野,512×512矩陣。掃描前經(jīng)肘靜脈置20G留置針,以5ml/s流速,用高壓注射器注射非離子型造影劑碘帕醇(Iopamidol,370mgI/ml)50ml,后繼續(xù)以相同速率注射生理鹽水30ml。胰腺全器官CT灌注掃描方案共包含掃描13組,每組掃描7s：2s的掃描時間和5s的間隔時間,總掃描時間85s。數(shù)據(jù)重建算法：iDose4Level4。數(shù)據(jù)處理采用第三方灌注軟件MIStar (Version3.2),測量26例正常胰腺組織的血流量(Blood Flow, BF)、血容量(Blood Volume, BV),毛細血管表面通透性(Permeability surface of product, PS)和平均通過時間(Mean transit time, MTT)將獲得數(shù)據(jù)進行統(tǒng)計學分析。 結(jié)果：全器官CT灌注正常胰腺血流量(BF)、血容量(BV)、表面通透性(PS)、平均通過時間(MTT)灌注值分別為：114.08±20.62mL/100g/min,19.34±2.45mL/100g,29.01±4.10mL/100g/min,7.12±2.19s。正常胰腺組織頭、體、尾部灌注參數(shù)的差異無明顯統(tǒng)計學意義(P0.05) 結(jié)論：全器官CT灌注正常胰腺表現(xiàn)為組織血流量、血容量、毛細血管平均通透性及造影劑平均通過時間均勻一致的實質(zhì)性臟器。 第二部分胰腺癌的256層螺旋CT全器官灌注成像研究 目的：通過對胰腺癌患者進行全胰腺CT灌注成像,獲得相關(guān)灌注參數(shù),探索胰腺癌的CT灌注的特征。 材料和方法：2011年1月至2013年3月收集36例胰腺癌病患者行全胰腺CT灌注。數(shù)據(jù)處理采用第三方灌注軟件MIStar(Version3.2),測量36例胰腺癌的血流量(BF),血容量(BV)、毛細血管表面通透性(PS)、平均通過時間(MTT)及PS/BF,將獲得數(shù)據(jù)進行統(tǒng)計學分析。 結(jié)果：胰腺癌組織的BF、BV、PS、MTT和PS/BF分別為：30.59±9.46mL/100g/min,6.59±2.41mL/100g,15.56±4.29mL/100g/min,7.69±3.11s和0.533±0.189。胰腺癌組織BV、BF、PS和PS/BF值與正常胰腺組織差異有明顯統(tǒng)計學意義,MTT差異無統(tǒng)計學意義。 結(jié)論：胰腺癌的CT灌注特征表現(xiàn)為組織血流量降低、血容量降低、毛細血管表面通透性降低、PS/BF比值升高、對比劑平均通過時間變化不明顯的惡性腫瘤。 第三部分胰腺癌256層螺旋CT灌注參數(shù)與MVD的相關(guān)性研究 目的：通過對手術(shù)切除的胰腺癌腫瘤標本進行CD31染色,測定胰腺癌和正常胰腺組織的微血管密度(MVD),結(jié)合胰腺癌的術(shù)前CT灌注參數(shù)進行相關(guān)性研究,探討功能性CT灌注成像對胰腺癌血管生成評價的可能性。 材料和方法：選取經(jīng)手術(shù)切除并獲取腫瘤組織、瘤周組織和正常組織的胰腺癌標本19例,對腫瘤組織、瘤周組織及正常組織標本行CD31抗體免疫組織化學染色,測定組織中的CD31陽性表達并進行微血管計數(shù),分析胰腺癌CT灌注參數(shù)與MVD的相關(guān)性。 結(jié)果：胰腺癌組織、瘤周組織及正常胰腺組織的MVD分別為122.25±40.21,245.85±40.17,311.35±52.03。胰腺癌組織的MVD顯著低于瘤周組織及正常胰腺組織,三者間差異均有統(tǒng)計學意義。MVD與灌注參數(shù)BF顯著正相關(guān)(P0.0001,r=0.874),其余灌注參數(shù)未發(fā)現(xiàn)與MVD的顯著相關(guān)性。 結(jié)論：胰腺癌CT灌注參數(shù)血流量與胰腺癌腫瘤微血管密度呈明顯正相關(guān),因此全胰腺CT灌注成像可作為活體評價胰腺癌血管生成的影像學方法。
[Abstract]:The CT perfusion features of normal pancreas and pancreatic cancer were measured by full - pancreas CT perfusion imaging , and the application value of all - pancreatic perfusion imaging in pancreatic cancer was explored .

Whole organ perfusion imaging of 256 - slice spiral CT in the first part of normal pancreatic tissue

Objective : To study the perfusion parameters of all organs in normal pancreatic tissue of patients with no pancreatic disease , and to explore the characteristics of the whole organ perfusion of normal pancreas .

Materials and Methods : Twenty - six patients with non - pancreatic diseases were collected from January 2011 to March 2013 .

Results : Normal pancreatic blood flow ( BF ) , blood volume ( BV ) , surface permeability ( PS ) , mean transit time ( MTT ) perfusion values were 114 . 08 鹵 20.62 mL / 100 g / min , 19.34 鹵 2.45 mL / 100 g , 29.01 鹵 4.10 mL / 100 g / min , and 7.12 鹵 2 . 19s respectively .

Conclusion : Normal pancreas in whole - organ CT perfusion is a substantial organ with uniform blood flow , blood volume , capillary mean permeability and average transit time of contrast agent .

Imaging Study of 256 - slice Spiral CT Whole Organ Perfusion Imaging in the Second Part of Pancreatic Cancer

Objective : To study the characteristics of CT perfusion of pancreatic cancer by performing full - pancreatic CT perfusion imaging on pancreatic cancer patients .

Materials and Methods : 36 patients with pancreatic cancer were collected from January 2011 to March 2013 . Data processing was performed with third - party perfusion software MIStar ( Version 3.2 ) . Blood flow ( BF ) , blood volume ( BV ) , capillary surface permeability ( PS ) , mean transit time ( MTT ) and PS / BF were measured in 36 patients with pancreatic cancer . The data were analyzed statistically .

Results : The BF , BV , PS , MTT and PS / BF of pancreatic carcinoma were 30.59 鹵 9.46mL / 100g / min , 6.59 鹵 2.41mL / 100g , 15.56 鹵 4.29mL / 100g / min , 7.69 鹵 3.11s and 0.533 鹵 0.189 respectively .

Conclusion : The characteristics of CT perfusion in pancreatic cancer are the decrease of tissue blood flow , the decrease of blood volume , the decrease of capillary surface permeability and the increase of PS / BF ratio .

A study on the correlation between the parameters of spiral CT perfusion and MVD in the third part of pancreatic cancer

Objective : To determine the microvessel density ( MVD ) of pancreatic cancer and normal pancreatic tissue by means of CD31 staining of pancreatic cancer tumor specimens from surgical resection , and to study the possibility of functional CT perfusion imaging on the evaluation of angiogenesis in pancreatic cancer .

Materials and Methods : 19 cases of pancreatic cancer specimens from tumor tissues , tumor tissues and normal tissues were resected and acquired by operation , and CD31 antibody immunohistochemical staining was performed on tumor tissues , tumor tissues and normal tissues . The expression of CD31 in tissues was measured and the correlation of CT perfusion parameters with MVD was analyzed .

Results : MVD was 122.25 鹵 40.21 , 245.85 鹵 40.17 , 311.35 鹵 52.03 , MVD was significantly lower than that of normal pancreatic tissue ( P < 0.01 , r = 0.874 ) .

Conclusion : The CT perfusion parameters of pancreatic cancer are positively correlated with the microvessel density of pancreatic cancer , so the whole pancreas CT perfusion imaging can be used as an imaging method to evaluate the angiogenesis in pancreatic cancer .

【學位授予單位】：復旦大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R735.9;R730.44

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本文編號：1864873