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目的通过对宫颈癌CT灌注成像及灌注参数、肿瘤内微血管密度(MVD)计数及其病理学特征进行分析,探讨CT灌注成像及灌注参数对宫颈癌生长、发展等生物学行为的诊断价值,探索CT灌注成像在宫颈癌的浸润、转移及预后评估中的临床应用价值。方法采集2012年1月-2014年11月确诊的40例宫颈癌患者(Ⅰb2~Ⅱb期)的组织标本,患者均于术前利用多排螺旋CT行灌注扫描;并取26例癌旁宫颈组织作为对照组;测定宫颈癌及瘤旁宫颈组织标本CT灌注成像数据,采集患者临床分期、分化程度、浸润深度及淋巴结转移信息,并与免疫组化结果进行统计学对照,通过χ2及独立样本t检验等方法分析各因素间的相关性。结果宫颈癌CT灌注成像及参数与MVD密切相关;宫颈癌组织时间-密度曲线(TDC)为速升型且峰值高,与癌旁宫颈组织的低平型曲线差异明显,具有一定的特征性;灌注参数BF/BV/MTT/PS均高于癌旁宫颈组织且差异有统计学意义(P<0.05),其中BF/BV/MTT值与MVD呈正相关;在宫颈癌不同临床分期、组织学分级及浸润深度等组中对照,灌注参数BF/BV/MTT差异有统计学意义(P<0.05)。结论宫颈癌CT灌注成像及灌注参数在辅助宫颈癌诊断、评估癌肿分期及侵袭情况、转移及预后评估等方面有重要的提示性作用,具有较高的临床应用价值。
Objective To evaluate the diagnostic value of CT perfusion imaging and perfusion parameters on the biological behavior of cervical cancer by CT perfusion imaging, perfusion parameters, intracranial microvessel density (MVD) count and pathological features. CT perfusion imaging in cervical cancer infiltration, metastasis and prognostic evaluation of clinical value. Methods Tissue specimens from 40 patients with cervical cancer (Ⅰb2 ~ Ⅱb) diagnosed from January 2012 to November 2014 were collected. The patients underwent multi-slice spiral CT perfusion scan before operation. Twenty-six patients with cervical cancer As a control group; CT perfusion imaging data of cervical cancer and para-tumorous cervical tissue specimens were collected and the clinical stage, differentiation degree, depth of invasion and lymph node metastasis were collected and statistically compared with the results of immunohistochemistry, through χ2 and independent samples t Test and other methods to analyze the correlation between the factors. Results CT perfusion imaging and parameters of cervical cancer were closely related to MVD. The time-density curve (TDC) of cervical cancer was ascending type and had a high peak, which was significantly different from that of the paracancerous cervical tissue. The perfusion parameters BF / BV / MTT / PS were significantly higher than those in the adjacent non-cancerous tissues (P <0.05), and the BF / BV / MTT values were positively correlated with the MVD in different clinical stages, histological grade And infiltration depth of the control group, perfusion parameters BF / BV / MTT difference was statistically significant (P <0.05). Conclusion CT perfusion imaging and perfusion parameters of cervical cancer have important implications in the diagnosis of cervical cancer, the evaluation of cancer staging and invasion, metastasis and prognosis assessment, which has a high clinical value.