| PART 1The functional parameters feature of dynamic enhanced CT in non-small cell lung cancerPurpose: TO evaluate the characteristics of dynamic enhanced CT in non-small cell lung cancer, and review related medical science literature to discuss its clinical value. Materials and Methods: Analyzed to the spiral CT dynamic enhancement findings Of 61 non-small cell lung cancer cases, observe the CT values of the lesion in each time, and draw enhancement time-density curves, the functional parameters: peak height(PH), the time to peak height(Tp), the ratio of PH of the mass to aorta(M/A) and perfusion value were calculated. Results: The CT values of the 61 cases were rapid increased and slowly decreased or not decreased, average value of the PH was (47.36±18.28)Hu, average value of the Tp was 76.25±27.52s, average value of the M/A was 0.22±0.08, average value of the perfusion was (0.26±0.11)ml·min-1·ml-1.Conclusions: The CT enhanced degree of non-small cell lung cancer is obvious, its largest enhancement value is most more than 20 HU, the maximum value often appears not more than 2 min,and the time-density curves often shows rapid increased and slowly decreased or not decreased, the dynamic enhanced characteristics is helpful in clinical diagnosis.PART 2The changes of quantitative parameters and clinical value of dynamic enhanced CT in non-small cell lung cancer before and after targeted therapyPurpose: To research the changes of quantitative parameters of dynamic enhanced CT in non-small cell lung cancer before and after targeted therapy, and compare with the traditional evaluation criteria, to find the parameters which can timely , objective evaluate the effect of targeted therapy.Materials and Methods: Collect 21 patients with targeted therapy who had received dynamic enhanced CT before and after treatment; scan with Multi-slice spiral CT, 120kV, 180mA, using non-ionic iodine contrast agent 1.5ml/Kg, with injection rate of 2.5～3ml/s; do dynamic enhanced CT scan after injecting contrast medium 15s,30s,45s,60s,75s,90s,(105s),120s,(135s),150s,(165s),180s,(195s),210s, observe the CT values of the lesion in each time, and draw enhancement time-density curves, the functional parameters: peak height(PH), the time to peak height(Tp), the ratio of PH of the mass to aorta(M/A) and perfusion value were calculated. Evaluate the effect of the treatment with PH, Tp, M/A, perfusion value, and compare with the result of effect with diameter, finding the parameters which had the same result with the diameter and make statistical analysis.Results: 21 patients had 33 rechecking results, when evaluating with the diameter, there were 19 improving cases, 7 stable cases, and 7 aggravated cases. Before therapy, the PH, Tp, M/A and perfusion value of the 19 improving cases were: 52.97±13.98HU,85.26±31.25s,0.18±0.07 and 0.28±0.11 ml·min-1·ml-1, and after therapy, the values were: 43.05±15.77HU,96.05±39.00s,0.16±0.06,0.18±0.09 ml·min-1·ml-1;Before therapy, the antecedent values of the 7 stable cases were: 42.43±12.89HU,117.85±27.96s,0.15±0.04,0.17±0.07 ml·min-1·ml-1,and after therapy, the values were: 47.71±15.20HU,124.28±38.45s,0.14±0.02,0.18±0.06 ml·min-1·ml-1;Before therapy, the antecedent values of the 7 aggravated cases were: 44.00±15.14HU,85.71±45.59s,0.17±0.06,0.21±0.08 ml·min-1·ml-1,and after therapy, the values were: 55.86±12.59HU,70.71±16.69s,0.24±0.10,0.34±0.11 ml·min-1·ml-1 . After comparison and statistical analysis, the results displayed: there was statistical significance in effective treatment or disease progression of PH and perfusion variation after targeted therapy, the PH and perfusion value decreases in effective patients, but increased in aggravated patients. Perfusion value changed the same with diameter of tumor. Perfusion value in improving patients after targeted therapy tended to decrease, in aggravated patients it tended to increase. The change of perfusion value preceded than diameter of tumor in reviewing in 3 case.Conclusions: Perfusion value changed the same with diameter of tumor in dynamic enhanced CT in non-small cell lung cancer patients after targeted therapy. We can evaluated the effective of targeted therapy by perfusion value changes. At the same time the change of perfusion value preceded than diameter of tumor. But we also need large sample study to make sure whether this result had good reproducibility. |
PDF Full Text Request