Clinical Study Of CT Perfusion Imaging And Angiogenesis In Pancreatic Adenocarcinoma

Using pancreatic perfusion CT imaging, the difference of pancreaticadenocarcinoma, acute pancreatitis and normal pancreas was investigated.The expression of microvascular density (MVD) and VEGF wasexamined in adenocarcinoma, paracarcinoma and chronic pancreatitis.The relation between CT perfusion and angiogenesis of pancreaticcarcinoma was discussed. Part Ⅰ Application of CT Perfusion Imaging to Diagnosing Pancreatic Adenocarcinoma Objective: Pancreatic adenocarcinoma homodynamic changes wereobserved comparing with pancreatic adenocarcinoma, acute pancreatitisand normal pancreas. The value of CT perfusion imaging for pancreaticadenocarcinoma diagnosis was investigated. Materials and methods: pancreatic adenocarcinoma (n=39), acutepancreatitis (n=12), normal pancreas (n=8) were studied. Eight secondsafter 4.0ml/s and 50ml contrast agent (300mg I/ml) bolus injection,dynamic enhancement scanning to chosen section using SiemensBodyPerfusion plan. Scanning parameters were 120-kV tube voltage,35-mAs tube current, 1-second acquisition time, 1-second circle time,dosage 90.3 CTDIw, and a BodyPerfusion plan. After dynamicenhancement scanning, intravenous injection of 50-60ml of contrast agent 6第二军医大学博士论文 英文摘要was given at 2.0ml/s and routine scanning was performed in 25 secondsand 45 seconds after injection. Images was transformed to MV300workstation, and managed with Siemens Perfusion CT/VA11A. Eightpseudocolour perfusion image were gained, so as to perfusion values byROI Evaluation. One-way ANOVA LSD,SNK and Dunnett 's C wereapplied. Results: Multisection spiral CT is very important for diagnosis ofpancreatic diseases, staging before operation, evaluation of resection andfollow-up after operation. BodyPerfusion plan can cover 2cm indynamically scanning pancreas, and display advantages of multisectionCT, but inevitably increased radiated dosage. The confliction of imagequality and radiation dosage is difficult to solve. The data of Flow,Blood Volume, Peak Enhancement, MIP, Sum Image gained frompancreatic adenocarcinoma group, acute pancreatitis group and normalpancreas group analyzed statistically, perfusion of pancreaticadenocarcinoma was lower than acute pancreatitis and normal pancreas,apart from Peak Enhancement, acute pancreatitis was not different fromnormal pancreas. Time to Start of three groups was not different. ForTime to Peak, group of pancreatic adenocarcinoma is longer than acutepancreatitis, and no difference from normal pancreas. All showed thathomodynamic data was generally descending for lower blood suppliedand easily necrotic pancreatic adenocarcinoma. Pseudocolour perfusion 7第二军医大学博士论文 英文摘要images were convenient for qualitative diagnosis of disease and had alimited value. Perfusion had to measure for quantitative analysis.Pancreatic perfusion was 84.11ml/min/100ml by deconvolution, and waslowered than that gained by peak upslope of the tissue time density curve.Reasons needed to investigate. Conclusion: Compared with acute pancreatitis and normal pancreas,pancreatic adenocarcinoma was descending in Flow, Blood Volume, Peakenhancement, MIP. Pseudocolour perfusion images were convenient forqualitative diagnosis of disease and had a limited value. Part Ⅰ Research for Angiogenesis of Pancreatic Adenocarcinoma Objective: Through detected with MVD and VEGF in pancreaticadenocarcinoma, chronic pancreatitis and normal pancreas, angiogenesisof pancreatic adenocarcinoma was investigated. Combined withpreoperational pancreatic CT perfusion, possibility of functional CTimaging applied to evaluate angiogenesis of pancreatic adenocarcinomawas investigated. Materials and met...