Clinical Application Of Multi-slice Spiral CT Perfusion In Diagnosis Of Pancreatic Adenocarcinoma

Background Now hundreds images can be acquired with multi-row detector CT(MDCT) in single scanning. The adoption of the technical high speed of many passage locators of scan, collection and operation of the speed, it makes the image of CT distinguish of space and time give attention to two sides, handles a great deal of data in a short time, and makes the picture and the value of perfusion of tumor of body more easily and accurately acquired. So the research of this aspect and application is more and more attractive. The perfusion of lymphoma, neck tumor, prostate gland cancer, primary hepatic carcinoma, and hepatic metastasis etc.have already been reported. The pancreatic tumors perfusion also has many reports.while the perfusion of normal pancreas is not widely reported. This report is to study the blood dynamics manifestation of pancreas in different sex, ages and locations using the multi- row detector CT perfusion imaging of the normal pancreas, and to measure the normal pancreatic tissue blood perfusion.Materials and methods 102 patients without pancreatic disorders (65 cases of male, 37 female, ages from 17 to 78 year, mean 48.2 ) were scanned with 16-row detector CT. Enhanced dynamic CT was performed, and the data were analyzed using commercial software to calculate pancreatic tissue blood flow (BF),peak enhancement image (PEI), time to peak (TTP), blood volume (BV) area product of different groups (divided by sex, age, and location). Perfusion parameters of different groups and different location of normal pancreatic tissue were compared.Results sex group: BF, PEI, TTP and BV in the head ,body and tail of normal pancreas between male and female were analyzed. (1) head of pancreas: statistically significant differences were noted between male and female according to BV(P＜0.05), which suggests the BV of normal pancreatic head of male is lower than that of female. (2) body of pancreas: statistically significant differences were noted between male and female according to BF(T-Test) P=0.01(P＜0.05),PEI(T-Test) P=0.0001(P＜0.05), TTP(T-Test) P=0.0025(P＜0.05), BV(T-Test) P=0.009(P＜0.05), and it suggests the BF, PEI,TTP and BV of normal pancreatic body of male is lower than that of female.(3) tail of pancreas: statistically significant differences were noted between male and female according to BF(T-Test) P=0.017(P＜0.05),PEI(T-Test) P=0.01(P＜0.05), BV(T-Test)P=0.015(P＜0.05), which suggests that the BF, PEI, and BV of normal pancreatic tail of male is lower than that of female.Age group: 102 patients without pancreatic disorders were divided into three groups by age, groupⅠ(33 cases≦40 years), groupⅡ(44 cases 40-60 years), groupⅢ(25 cases＞60 years). Statistically significant differences were noted between groupⅢand groupⅠin normal pancreatic body tissue according to BV (P＜0.05), and it suggests the BV of normal pancreatic body of groupⅢis lower than that of groupⅠ; Statistically significant differences were noted between groupⅡand groupⅠin normal pancreatic tail tissue according to BF (P＜0.05), and it shows us that the BF of normal pancreatic tail of groupⅡis lower than that of groupⅠ.Location group: 102 patients without pancreatic disorders were divided into three groups(head, body and tail) by location. Statistically significant differences were noted between head and tail in normal pancreatic tissue according to BF, PEI, TTP and BV (P＜0.05), and it suggests the BF, PEI, TTP and BV of normal pancreatic head is lower than that of the tail. No Statistically significant differences were noted neither between head and body nor between body and tail in normal pancreatic tissue(P＞0.05). Conclusion There are different blood flow values 0fhead, body and tail in normal pancreatic tissue in different sex. The blood flow values of normal pancreas decreases in elder people. The blood flow value of the head of pancreas is lower than that of the tail in normal cases. Background The pancreatic carcinoma is usually in clinical, yet diagnosis is often difficult, because of its location and nonspecific feature of images. CT diagnosis of pancreatic carcinoma depends on the changes of pancreatic appearance and different density between the lesion and the normal tissue. The main method of pancreatic carcinoma diagnosis is the CT enhancement scanning, but it can not accurately show the characteristics of blood flow of pancreatic cancer. A new way of CT perfusion has been used, along with the applications of multi-row detector spiral CT. It illustrates the blood supply of parenchymal phase. Measuring the blood flow value of pancreas can be used to identify patients with pancreatic carcinoma.Materials and methods 50 patients of pancreatic cancer (32 cases were then confirmed by pathology, and 18 cases were confirmed by clinical and image) formed the experimental group, 50 patients without pancreatic disorders(from partⅠ) served as control group. All the 50 patients were more than 40 years old. The lesion was in the head of pancreas in 37 cases, in the body and tail in 13 cases. 21 male patients and 16 female patients had lesion in the head of pancreas. 8 male and 5 female patients lesion had in the body and tail of pancreas. In the control group, all the 50 people with normal pancreas were older than 40 years, among them 30 male and 20 female. Perfusion CT was performed with 16- row detector spiral CT in both the experiment group and control group. Enhanced dynamic CT was performed, and the data were analyzed using commercial software to calculate tissue blood flow (BF),blood volume (BV), peak enhancement image (PEI), time to peak (TTP), mean transit time (MTT, MTT=BV/BF). Perfusion parameters of normal pancreas, tumor tissues and the pancreatic tissue near tumors were compared.Result (1) 37 cases of the carcinoma in head of pancreas: Statistically significant differences were noted among 21 cases of male of the carcinoma of head of pancreas and the body of normal pancreatic tissue and 30 cases of control group with respect to BF, PEI, TTP, BV, MTT (P＜0.05). BF, PEI, BV, MTT showed higher and lower TTP compared with those of the carcinoma of head of pancreas. There was no remarkable differences between the body of pancreatic cancer and normal pancreas; Statistically significant differences were noted among 16 cases of female of the carcinoma in head of pancreas and the body of normal pancreatic tissue and 20 cases of control group with respect to BF, PEI, TTP, BV, MTT (P＜0.05). BF, PEI, BV, MTT showed higher and lower TTP compared with those of the carcinoma of head of pancreas. There was no remarkable differences between the body of pancreatic cancer and normal pancreas. (2) 13 cases of the carcinoma of body and tail of pancreas: Statistically significant differences were noted among 8 cases of male of the carcinoma of body an tail of pancreas and the head of normal pancreatic tissue and 30 cases of control group with respect to BF, PEI, TTP, BV, MTT (P＜0.05). BF, PEI, BV, MTT showed higher and lower TTP compared with those of the carcinoma of head of pancreas; Statistically significant differences were noted among 5 cases of female of the carcinoma of body and tail of pancreas and 20 cases of control group with respect to BF, PEI, TTP, BV, MTT (P＜0.05).BF, PEI, BV, MTT showed higher and lower TTP compared with those of the carcinoma of head of pancreas. There was significant difference between the carcinoma of body and tail of pancreas and the pancreatic tissue near tumors, TTP was no statistical differences.Conclusion CT perfusion imaging can be used to identify patients with pancreatic disease, and may play an important role in diagnosis for pancreatic carcinoma.