| IntroductionThe pancreatic cancer has become one of the familiar digestive system maligant tumors currently,account for about 95%in pancreatic malignant tumors and 1%-4% of the whole body maligant tumors and the trend is increasing grandually in the whole world.To diagnose pancreatic cancer in the inatial stages is crucial in certain circumstances.Most patients are in the later period when they go to hospital,so its operational excision rate become low.CT is often used,while contrast CT imaging is more often used.With technique developing,CT perfusion imaging has been applied to many kinds of diseases in several organs.Especially,multi-slice CT(MSCT)is faster, which make perfusion CT very precise.Importance of CT perfusion imaging to help diagnosis pancreatic cancer should be noticed.PurposeThe aim of this study is to evaluate the feasibility of MSCT perfusion imaging in pancreas.Investigate the 64-slice CT perfusion characters of normal pancreas and pancreatic cancer.Materials and Methods1.Usual materialsCT perfusion imaging was performed in 116 patients.Among them,55 healthy subjects without pancreatic diseases and 61 patients with pancreatic cancer were included.2.Examining method(1)Routine CT scan to locate with a 64-slice CT scanner(SOMATOM Sensation 64,Siemens,Germany).(2)Healthy subjects and patients with pancreatic caner underwent CT perfusion imaging.High pressure syringe was used,using trochar.50ml contrast medium (Omnipaque,300mlI/ml,5ml/s).The dynamic scan protocol was as follow:7.2mm/four slice,scan every second for 70s,each perfusion CT got 280 images totally.Tube tension 100KV,tube current 80mA,matrix 512x512,FOV 26cm.3.CT diamnosisDiagnoses were made by two doctors separately.Patients with pancreatic cancer were classified to type 1,2,3,or 4 according to Hemrick standard.4.Perfusion parameters and analysisData was translated to syngo workstation,and post-processing was performed with Body PCT(Siemens,Germany).The celiac 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 intrest(ROI).5.Statistical analysisSPSS12.0 statistical software in used to analyze data.The each group number adopts mean standard deviation.We make t test and pearson correlation between the every parameter of two group samples,and consider it having statistical significance when P＜0.05.ResultMean values of BF,BV,PE,TTP and P of normal pancreas are 150.30±51.55ml/ 100ml/min,26.02±11.93ml/100ml,56.62±11.17Hu,23.99±5.06s and 24.86±15.72ml/ 100/min.Pancreatic cancer values are 47.94±27.25 ml/100ml/min,11.85±7.40ml/100 ml,32.04±9.40Hu,5.50±9.40s and 61.92±28.31ml/100/min.Pancrestic cancer shows significantly lower values of BF,BV and PE compared to normal pancreas,but higher TTP and P has significantly statistical difference with that of normal pancreas(P＜0.05).Paired-samples t test was used in 46 patients between pancreatic cancer tissue and the relative normal pancreas tissue of peri-tumor.Cancer tissue showed lower BF, BV and PE,but higher TTP and P compared with normal tissue(P＜0.05).The every group perfusion parameter has no significantly statistical difference between normal pancreas and the relative normal pancreas tissue of peri-tumor(P＞0.05).BF,BV,and P of the perfusion parameter of the pancreatic cancer obviously increase along with the increment of the Hemrick CT period,they present obviously positive correlation,and has statistical difference(P＜0.01).Convlusion1.Perfusion imaging with MSCT is feasible,simple and fast.It can assess blood perfusion of pancreas.It proves to be a non-invasive option in the diagnosis of pancreatic cancer.2.BF,BV,and P of the perfusion parameter of the pancreatic cancer present positive correlation along with the increment of the Hemrick CT period.3.Compared of perfusion parameters of the relative normal pancreas tissue of peri-tumor and pancreatic cancer tissue in the same patient help diagmosis pancreatic cancer. |
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