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目的探讨乳腺病变 CT 灌注的血流特征及其临床意义。方法 22例乳腺癌及11例乳腺良性病变均经手术或穿刺活检证实。先行 CT 平扫,确定肿块后行多同层电影模式灌注扫描。在 AW 4.1工作站使用 perfusion3软件包分别测量乳腺肿块边缘区域、肿块中心区域及化疗前、后(7例)的血流量(BF)、血容量(BV)、平均通过时间(MTT)及表面通透性乘积(PS),并对恶性肿块边缘区域与中心区域、良性肿块及化疗前、后分别进行统计学分析。肿瘤的血流灌注值用肿瘤生长活跃的边缘区域血流灌注值代表。结果乳腺癌肿块边缘与乳腺良性病变的 BF、BV、MTT 及 PS 的中位值分别为31.78 ml·min~(-1)·100 g~(-1)、6.98 ml·100 g~(-1)、12.13 s、16.34 ml·min~(-1)·100 g~(-1)和10.45 ml·min~(-1)·100 g~(-1)、2.02 ml·100 g~(-1)、15.49 s、3.33 ml·min~(-1)·100 g~(-1);乳腺癌肿块中心区域的 BF、BV、MTT 及 PS 的灌注值的中位数分别为23.07 ml·min~(-1)·100 g~(-1)、2.43 ml·100 g~(-1)、11.77 s、5.99 ml·min~(-1)·100 g~(-1);7例乳腺癌化疗前后的 BF、BV、MTT 及 PS 的差值中位数为15.02 ml·min~(-1)·100 g~(-1)、1.93 ml·100 g~(-1)、1.98 s、8.01 ml·min~(-1)·100 g~(-1)。乳腺良恶性肿块、恶性肿块边缘与中心区域及乳腺癌肿块化疗前后的 BF、BV 及 PS 的灌注值差异均有统计学意义(P 值均<0.05),而其 MTT 差异无统计学意义(P>0.05)。结论 CT 灌注可以间接地反映了乳腺癌的生物学行为,对乳腺癌的诊断、预后评估及化疗疗效评价可能具有重要的临床价值。
Objective To investigate the characteristics and clinical significance of CT perfusion in breast lesions. Methods 22 cases of breast cancer and 11 cases of benign breast lesions were confirmed by surgery or biopsy. First CT scan, OK after the line mass film mode perfusion scan. At the AW 4.1 workstation, the perfusion3 software package was used to measure the blood flow (BF), blood volume (BV), mean transit time (MTT), and surface permeability of the breast tumor in the marginal region, central mass of the tumor and before and after chemotherapy (PS), and statistical analysis was made on the marginal and central regions of malignant tumor, benign tumor and before and after chemotherapy. Tumor perfusion values are represented by borderline perfusion values for tumor growth. Results The median values of BF, BV, MTT and PS in breast cancer margin and benign breast lesions were 31.78 ml · min -1 · 100 g -1 · 6.98 ml · 100 g -1 ), 12.13 s, 16.34 ml · min -1 · 100 g -1 and 10.45 ml · min -1 · 100 g -1, 2.02 ml · 100 g -1 ), 15.49 s, 3.33 ml · min -1 · 100 g -1, respectively. The median perfusion values of BF, BV, MTT and PS in the central area of breast cancer mass were 23.07 ml · min ~ (-1) 100 g -1, 2.43 ml · 100 g -1, 11.77 s, 5.99 ml · min -1 -100 g -1, respectively. Seven cases of breast cancer chemotherapy The median difference between BF, BV, MTT and PS before and after treatment was 15.02 ml · min -1 · 100 g -1 · 1.93 ml · 100 g -1 · 1.98 s · 8.01 ml · Min -1 (-1) · 100 g -1. The difference of BF, BV and PS perfusion between benign and malignant breast masses, margins and centers of malignant tumors, and breast cancer mass before and after chemotherapy were statistically significant (P <0.05), but there was no significant difference in MTT (P > 0.05). Conclusion CT perfusion indirectly reflects the biological behavior of breast cancer. It may have important clinical value in the diagnosis, prognosis evaluation and evaluation of chemotherapy efficacy in breast cancer.