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目的探讨CT灌注成像技术对定量评价肿瘤组织血流动力学改变,区分肿瘤组织和正常组织、肿瘤中心组织和肿瘤边缘组织的有效性,以及定量监测肿瘤微血管系对抗血管生成药物治疗反应的有效性。方法 15只一侧大腿植入VX2肿瘤的新西兰大白兔分为2组,1组行抗血管治疗(n=11),1组为对照组(n=4)。于肿瘤种植1周后、治疗1周后和治疗2周后进行DEC-CT扫描,分别计算肿瘤区、肿瘤边缘区、肿瘤中心区和正常组织区的灌注参数:血流量(blood flow,BF)、血容量(blood volume,BV)、平均通过时间(meantransit time,MTT)和表面通透性(permeability surface,PS),并对各灌注参数值进行统计分析。结果肿瘤区和正常组织区的BF、PS、MTT值分别为(149.32±30.99)ml/(100g.min)、(28.24±5.15)ml/(100g.min)、(2.79±0.66)s和(32.18±4.10)ml/(100g.min)、(11.88±0.71)ml/(100g.min)、(6.57±0.90)s,两者比较差异均有统计学意义(P<0.01)。肿瘤核心区和肿瘤边缘区的BF、PS、MTT值分别为(175.70±34.43)ml/(100g.min)、(32.43±6.52)ml/(100g.min)、(3.87±0.84)s和(19.07±3.58)ml/(100g.min)、(18.75±2.10)ml/(100g.min)、(8.11±1.44)s,两者比较差异均有统计学意义(P<0.05)。治疗组肿瘤区的BF、BV、PS、MTT值在治疗后第2周后从187.57ml/(100g.min)、5.21ml/100g、30.74ml/(100g.min)、3.87s改变为118.48ml/(100g.min)、4.21ml/100g、24.02ml/(100g.min)、4.27s,对照组从129.74ml/(100g.min)、3.22ml/100g、25.85ml/(100g.min)、3.68s改变为362.33ml/(100g.min)、10.86ml/100g、39.31ml/(100g.min)、3.54s,改善明显。结论 CT灌注成像技术能从血流动力学方面提供肿瘤定量信息,并能定量监测肿瘤微血管系对抗血管生成药物治疗的反应。
Objective To evaluate the effectiveness of CT perfusion imaging in the quantitative evaluation of hemodynamic changes in tumor tissue, differentiation of tumor tissue from normal tissue, tumor center tissue and tumor marginal tissue, and to quantitatively monitor the effect of tumor microvasculature on anti-angiogenic drug response . Methods Fifteen New Zealand white rabbits implanted with VX2 tumors on one thigh were divided into 2 groups. Group 1 received anti-angiogenic therapy (n = 11) and group 1 received control (n = 4). One week after tumor implantation, one week after treatment and two weeks after treatment, DEC-CT scan was performed to calculate perfusion parameters of tumor area, tumor marginal area, tumor center area and normal tissue area respectively: blood flow (BF) , Blood volume (BV), mean transit time (MTT) and permeability surface (PS) were measured. The perfusion parameters were statistically analyzed. Results The values of BF, PS and MTT in tumor area and normal tissue were (149.32 ± 30.99) ml / (100g.min), (28.24 ± 5.15) ml / (100g.min), (2.79 ± 0.66) s and 32.18 ± 4.10), (11.88 ± 0.71) ml / (100g.min) and (6.57 ± 0.90) s respectively. There was significant difference between the two groups (P <0.01). The values of BF, PS and MTT in the tumor core and tumor margins were (175.70 ± 34.43) ml / (100g.min), (32.43 ± 6.52) ml / (100g.min), (3.87 ± 0.84) s and 19.07 ± 3.58), (18.75 ± 2.10) ml / (100g.min) and (8.11 ± 1.44) s respectively. There was significant difference between the two groups (P <0.05). The BF, BV, PS and MTT in the tumor area of the treatment group were changed from 187.57ml / (100g.min), 5.21ml / 100g, 30.74ml / (100g.min) and 118.48ml (100g.min), 4.21ml/100g, 24.02ml/(100g.min),4.27s, and the control group from 129.74ml / (100g.min), 3.22ml / 100g, 25.85ml / (100g.min) 3.68s to 362.33ml / (100g.min), 10.86ml / 100g, 39.31ml / (100g.min), 3.54s, the improvement is obvious. Conclusions CT perfusion imaging provides quantitative information on tumor hemodynamics and quantitatively monitors the response of tumor microvasculature to antiangiogenic drug therapy.