| PrefacePancreatic cancer accounts for 95％in pancreatic malignant tumours. To diagnosepancreatic cancer in the inatial stages is crucial in certain circumstances. Most patientsare in the later period when they go to hospital, so its operational excision rate becomelow. CT is often used, while contrast CT imaging is more often used. With techniquedeveloping, CT perfusion imaging has been applied to many kinds of diseases inseveral organs. Especially, 64-MSCT is faster, which make perfusion CT very precise.Importance of CT perfusion imaging to help diagnose pancreatic cancer should benoticed.PurposeThe aim of this study is to evaluate the feasibility of 64-CT perfusion imaging inpancreas. Investigate the 64-CT perfusion characters of normal pancreas and pancreaticcancer to help diagnose.Materials and Methods1. Usual materialsCT perfusion imaging was performed in 55 patients from Dec. 2005 to Apr. 2007.Among them, 24 healthy subjects without pancreatic diseases and 35 patients withpancreatic cancer were included.2. Examining method(1) Routine CT scan to locate with a 64-CT scanner (SOMATOM Sensation 64, Siemens, Germany).(2) Healthy subjects and patients with pancreatic cancer underwent CT perfusionimaging. High pressure syringe was used, using trochar. 50ml contrast medium(Omnipaque, 300mgI/ml, 5ml/s). The dynamic scan protocol was as follows: scanevery second for 70s, each perfusion CT got 280 images totally. Tube tension 100kV,tube current 80mA, matrix 512×512, FOV 26cm.3. CT diagnosisDiagnoses were made by two doctors separately. Patients with pancreatic cancerwere classified to type 1, 2, 3, or 4 according to Hemrick standard.4. Perfusion parameters and figure analysisPost-processing was performed with syngo Body PCT (Siemens, Germany). Theceliac artery was accepted as feeding vessel. Perfusion parameters blood flow (BF),blood volume (BV), peak enhancement (PE), time to peak (TTP), and permeability (P)were measured within region of interest (ROI).5. Statistical analysisIndependent samples t test was used between normal pancreas and pancreaticcancer and between pancreatic cancer type 1 and the other. Paired-samples t test wasused between normal pancreatic tissue and parenchyma of pancreatic cancer (SPSS10.0). P＜0.05 is considered to be statistically significant.Results1. Classification of pancreatic cancer.Type 1 pancreatic cancer accounts for only 22.9%.2. Perfusion parameters of normal pancreas and pancreatic cancer.Pancreatic cancer shows significantly lower values of BF, BV and PE compared tonormal pancreas, but higher TTP and P, as was proven by the independent sample t test(P＜0.05). Mean values of BF, BV, PE, TTP and P of pancreatic cancer are 0.472± 0.125ml/ml/min, 0.136±0.018ml/ml, 32.5±5.0HU, 53.7±5.4s and 53.3±7.4.Normal values are 11.613±0.100ml/ml/min, 0.262±0.032ml/ml, 57.9±8.8HU, 25.2±+3.7s and 18.1±6.8.3. Perfusion parameters of normal tissue and pancreatic cancer tissuein the same patient.In 1 pancreatic cancer patients, normal tissue couldn't be obtained due to the sizeof the tumor. Paired-samples t test was used in the other 34 patients between normalpancreatic tissue and parenchyma of pancreatic cancer. Cancer showed lower BF, BVand PE, but higher TTP and P compared with normal tissue (P＜0.05).4. Perfusion parameters comparation between pancreatic cancer type1 and the other.Pancreatic cancer type 2, 3, 4 showed higher P compared with type 1(P＜0.05).There was no significant difference between them in BF, BV, PE and TTP.Conclusion1. Perfusion imaging with 64 slice CT is feasible, simple and fast. It can assessblood perfusion of pancreas.2. CT perfusion imaging can give quantitative measurements. It proves to be anon-invasive option in the diagnosis of pancreatic cancer.3. Comparation of perfusion parameters of normal tissue and pancreatic cancertissue in the same patient help diagnose pancreatic cancer.4. P means the permeability of blood vessels. P can reflect the destruction of bloodvessels. |
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