The assessed value of 64 slice spiral CT perfusion imaging in laryngeal squamous cell carcinoma after chemotherapy and radiotherapy
-
摘要: 目的:探讨64层螺旋CT灌注成像对喉鳞状细胞癌放化疗后病情评估的价值。方法:对45例局部晚期喉鳞状细胞癌患者均分别在治疗前和放疗剂量达40 Gy时行常规CT增强扫描和CT灌注成像检查,并同时测量血流量、血容量、平均通过时间和表面通透性,再根据末次检查时肿瘤体积减小的百分率将患者分为敏感组及非敏感组,并将各项肿瘤灌注指标进行对比。结果:敏感组在放疗剂量达40 Gy时血流量、血容量、表面通透性均较治疗前降低,而非敏感组均上升(P<0.05);血流量、血容量、平均通过时间、表面通透性等参数ROC曲线下面积分别为0.804、0.843、0.852、0.826,血流量敏感性、特异性和准确性分别为89.7%、86.8%和90.9%,血容量为100.0%、91.4%和93.7%,平均通过时间为100.0%、67.7%和88.3%,表面通透性为91.2%、69.4%和90.6%(均P<0.01)。结论:64层螺旋CT灌注成像检查对于喉鳞状细胞癌患者放化疗后病情有较好的评估价值。Abstract: Objective:To study the assessed value of 64 slice spiral CT perfusion imaging (CTPI) in laryngeal squamous cell carcinoma after chemotherapy and radiotherapy. Method:Forty five patients diagnosed with local advanced laryngeal squamous cell carcinoma were selected. Conventional CT and CTPI were performed before treatment and at the time of radiation dose up to 40 Gy. Blood flow, blood volume, mean transit time and surface permeability were measured at the same time. According to the decrease of tumor volume in final examination, patients were divided into sensitive group and insensitive group. The tumor perfusion indexes were compared between groups.Result:Blood flow, blood volume, surface permeability after 40Gy treatment were lower than before treatment in both sensitive group and the insensitive group ascended(P<0.05). The AUC of ROC of blood flow, blood volume, mean transit time and surface permeability were 0.804, 0.843, 0.852 and 0.826. The sensitivity, specificity and accuracy of blood flow was 89.7%, 86.8% and 90.9%. There were 100.0%, 91.4% and 93.7% in blood volume; 100.0%, 67.7% and 88.3% in mean transit time; 91.2%, 69.4% and 90.6% in surface permeability(P<0.01).Conclusion:Sixty-four slice spiral CT perfusion imaging is able to assess tumor status of laryngeal squamous cell carcinoma after chemotherapy and radiotherapy effectively.
-
[1] 周小娟,张俊杰,谭国林,等.SHIP2在喉鳞状细胞癌中的表达及意义[J].中国耳鼻咽喉颅底外科杂志,2011,17(5):32-33.
[2] ZIPS D,ZÖPHEL K,ABOLMAALI N,et al.Exploratory prospective trial of hypoxia-specific PET imaging during radiochemotherapy in patients with locally advanced head-and-neck cancer[J].Radiother Oncol,2012,105:21-28.
[3] 龚虹云,宋启斌,胡伟国,等.首选化放疗或手术治疗喉癌疗效的系统评价[J].循证医学,2014,14(4):229-233.
[4] JANSEN J F A,KOUTCHER J A,SHUKLADAVE A.Non-invasive imaging of angiogenesis in head and neck squamous cell carcinoma[J].Angiogenesis,2010,13:149-160.
[5] 王峰,任凌,李眉,等.喉和鼻咽鳞状细胞癌整合素αvβ3放射性核素显像实验研究[J].中华核医学与分子影像杂志,2012,32(2):143-147.
[6] FAGGIONI L,NERI E,CERRI F,et al.64-row MDCT perfusion of head and neck squamous cell carcinoma:technical feasibility and quantitative analysis of perfusion parameters[J].Eur radiol,2011,21:113-121.
[7] SHUKLA-DAVE A,LEE N Y,JANSEN J F,et al.Dynamic contrast-enhanced magnetic resonance imaging as a predictor of outcome in head-and-neck squamous cell carcinoma patients with nodal metastases[J].Int J Radiat Oncol Biol Phys,2012,82:1837-1844.
[8] ŠURLAN-POPOVIČK,BISDAS S,RUMBOLDT Z,et al.Changes in perfusion CT of advanced squamous cell carcinoma of the head and neck treated during the course of concomitant chemoradiotherapy[J].AJNR Am J Neuroradiol,2010,31:570-575.
[9] 周小娟,张俊杰,谭国林,等.SHIP2在喉鳞状细胞癌中的表达及意义[J].中国耳鼻咽喉颅底外科杂志,2011,17(5):43-45.
[10] BAUGNON K L,BEITLER J J.Pitfalls in the staging of cancer of the laryngeal squamous cell carcinoma[J].Neuroimaging Clin N Am,2013,23:81-105.
[11] JO S Y,WANG P I,NÖR J E,et al.CT perfusion can predict overexpression of CXCL8(interleukin-8)in head and neck squamous cell carcinoma[J].AJNR Am J Neuroradiol,2013,34:2338-2342.
[12] 李俊,王建中,黄新生,等.喉鳞癌中microRNA-197表达水平的研究[J].中国临床医学,2013,2(4):443-446.
[13] 张文超,张强,张仑.术前临床N0期喉鳞癌临床特点与预后分析[J].中华临床医师杂志,2010,4:34-37.
[14] DU Y,PEYSER N D,GRANDIS J R.Integration of molecular targeted therapy with radiation in head and neck cancer[J].Pharmacol Ther,2014,142:88-98.
[15] TROJANOWSKA A,TROJANOWSKI P,BISDAS S,et al.Squamous cell cancer of hypopharynx and larynx-evaluation of metastatic nodal disease based on computed tomography perfusion studies[J].Eur J Radiol,2012,81:1034-1039.
计量
- 文章访问数: 36
- PDF下载数: 18
- 施引文献: 0