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目的探讨动态容积CT灌注联合能谱成像在射频消融(RFA)治疗肺癌近期疗效观察中的应用价值。方法收集已经病理结果证实并拟行治疗的肺腺癌患者30例,术前1~2 d和术后30~40 d均行病灶部位灌注扫描,根据原始图像重建出能谱图像,并对比术前、术后灌注参数血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)及能谱参数碘(水)基值、水(碘)基值的变化,分析灌注参数及能谱参数对评价RFA治疗肺癌近期疗效的意义。结果 RFA后,全组患者的CT灌注参数及能谱参数值均值均下降,BF(t=7.34,P<0.001)、BV(t=4.721,P<0.001)、PS(t=2.224,P=0.034)、动脉期碘(水)基值(t=8.622,P<0.001)、静脉期碘(水)基值(t=6.608,P<0.001)及动脉期水(碘)基值(t=4.627,P<0.001)术前、术后近期差异有统计学意义。RFA前后,缓解组的各参数变化差值均大于复发组,但只有BF(Z=-2.806,P=0.005)、动脉期碘(水)基值(Z=-2.806,P=0.005)及静脉期碘(水)基值(Z=-4.208,P=0.014)变化差值有统计学意义。结论 CT灌注联合能谱成像是一种评价RFA治疗肺癌近期疗效的有效方法。
Objective To investigate the value of dynamic volumetric CT perfusion combined with energy spectrum imaging in the short term radiofrequency ablation (RFA) in the treatment of lung cancer. Methods Thirty patients with pathologically confirmed lung adenocarcinoma were enrolled in this study. Thirty patients with lung adenocarcinoma were treated by perfusion scanning 1-2 days before surgery and 30-40 days after surgery. The images were reconstructed from the original images and compared with those from contrast Before and after perfusion, parameters such as blood flow (BF), blood volume (BV), mean transit time (MTT), surface permeability (PS) and energy spectrum parameters iodine (water) Changes, analysis of perfusion parameters and spectral parameters of the evaluation of RFA treatment of lung cancer in the short term effect. Results After RFA, the mean values of CT perfusion parameters and energy spectrum parameters decreased in all groups (P <0.001), BF (t = 7.321, P < 0.034), basal iodine (t = 8.622, P <0.001), basal iodine (t = 6.608, P <0.001) and arterial phase water iodine (t = 4.627, P <0.001), there were significant differences in short-term and postoperative short-term. Before and after RFA, the differences of all the parameters in remission group were more than those in the recurrence group, but only the basal iodine (water) (Z = -2.806, P = 0.005) and venous The difference of iodine (water) basis value (Z = -4.208, P = 0.014) was statistically significant. Conclusion CT perfusion combined with energy spectrum imaging is an effective method to evaluate the short-term efficacy of RFA in the treatment of lung cancer.