【作者】 姜海峰；

【导师】 郭顺林；

【作者基本信息】 兰州大学 ， 影像医学与核医学， 2009， 硕士

【摘要】 目的应用64层螺旋CT灌注成像技术测量及评价正常胰腺和急性胰腺炎的血流动力学表现,并进一步探讨其在急性胰腺炎影像诊断中的作用。材料与方法分别对胰腺正常者30例和急性胰腺炎患者28例行Siemens 64层螺旋CT胰腺灌注检查,采用Siemens Body Perfusion软件测量所有病例的胰头部、胰体尾部的CT灌注参数:血流量（Blood flow,BF）、血流容积（Blood volume,BV）、灌注起始时间（Time to start perfusion,TTS）、达峰时间（Time to peak perfusion,TTP）、渗透性（permeability,P.）、patlak血流容积（patlak Blood volume,pBV）的平均值,并进行统计学分析。结果Siemens灌注软件计算所得时间-密度曲线（TDC）符合数据分析要求。正常胰腺组胰头部的BF、BV、TTS、TTP、permeability和pBV分别为:（103.94±34.84）ml·100ml^-1·min^-1、（259.69±49.39）ml/L、（26.13±12.69）0.1s、（161.15±27.73）0.1s,（82.21±17.51）0.5ml·100ml^-1·min^-1和（138.24±58.43）ml/L;正常胰腺组胰体尾部的BF、BV、TTS、TTP、permeability和pBV分别为:（110.15±36.78）ml·100 ml^-1·min^-1、（242.86±45.71）ml/L、（21.49±2.75）0.1s、（147.04±25.58）0.1s、（78.01±15.37）0.5ml·100ml^-1·min^-1和（146.87±54.19）ml/L。急性胰腺炎组胰头部的BF、BV、TTS、TTP、permeability和pBV分别为:（69.09±22.92）ml·100ml^-1·min^-1、（186.02±47.36）ml/L、（25.00±5.52）0.1s、（144.47±22.97）0.1s、（95.27±11.65）0.5 ml·100 ml^-1·min^-1和（96.52±37.99）ml/L;急性胰腺炎组胰体尾部的BF、BV、TTS、TTP、permeability和pBV分别为:（71.08±16.67）ml·100ml^-1·min^-1、（184.07±46.91）ml/L、（24.35±4.99）0.1s、（144.08±22.17）0.1s、（89.88±14.74）0.5ml·100 ml^-1·min^-1和（107.50±32.18）ml/L。统计结果显示急性胰腺炎组胰头部和体尾部的BF、BV、pBV明显低于正常胰腺组,而其渗透性高于正常胰腺组,差异均有显著的统计学意义（P＜0.05）;两组内胰头部及胰体尾部各自的TTS和TTP比较无统计学意义（P＞0.05）;急性胰腺炎组、正常胰腺组各自的胰头部与胰体尾部之间各灌注参数无统计学意义（P＞0.05）。结论正常胰腺组和急性胰腺炎组的CT灌注参数比较有显著性差异,64层螺旋CT灌注成像能够反映急性胰腺炎的血流灌注改变,对其临床的早期诊断有重要的指导意义。更多还原

【Abstract】 ObjectiveTo assess the characteristics of blood flow for normal pancreas and acute pancreatitis by using 64-slice spiral CT perfusion imaging,and to investigate the value of 64-slice spiral CT perfusion technology in imagic diagnosis of acute pancreatitis.MethodsSiemens Somatom 64-slice spiral CT perfusion scan of pancreas was performed in 30 patients with normal pancreas tissue and 28 patients with acute pancreatitis. The mean blood flow（BF）,blood volume（BV）,time to start perfusion（TTS）,time to peak perfusion（TTP）,permeability（P.） and patlak blood volume（pBV） in the head of pancreas and pancreatic tail were measured by Siemens Body Perfusion software package,and then the statistical analysis was performed.ResultsThe density-time curve（TDC） of CT perfusion calculated by Siemens Body perfusion software package was satisfactory.In the normal pancreas group,the mean BF,BV,TTS,TTP,permeability and pBV at the head of pancreas were: （103.94±34.84）ml·100ml^-1min^-1,（259.69±49.39）ml/L,（26.13±12.69）0.1s, （161.15±27.73）0.1s,（82.21±17.51）0.5ml·100ml^-1·min^-1,（138.24±58.43）ml/L, respectively,and those at pancreatic tail were（110.15±36.78）ml·100ml^-1·min^-1, （242.86±45.71）ml/L,（21.49±2.75）0.1s,（147.04±25.58）0.1s,（78.01±15.37） 0.5ml·100ml^-1·min^-1 and（146.87±54.19） ml/L,respectively.In the acute pancreatitis group,the mean BF,BV,TTS,TTP,permeability and pBV at the head of pancreas were（69.09±22.92）ml·100ml^-1·min^-1,（186.02±47.36）ml/L,（25.00±5.52）0.1s, （144.47±22.97）0.1s,（95.27±11.65）0.5ml·100ml^-1·min^-1,（96.52±37.99）ml/L, respectively,and those at pancreatic tail were（71.08±16.67） ml·100ml^-1·min^-1, （184.07±46.91）ml/L,（24.35±4.99）0.1s,（144.08±22.17）0.1s,（89.88±14.74） 0.5ml·100ml^-1·min^-1and（107.50±32.18） ml/L,respectively.Statistical analysis showed that the values of BF、BV and pBV at the head of pancreas and pancreatic tail in acute pancreatitis group were lower than those of the normal group,however the value of permeability increased compared to the normal group,and the difference was significant（P＜0.05）.Whereas,the mean TTS and TTP between two groups at either the head of pancreas or pancreatic tail were not statistically significant（P＞0.05）.In those all CT perfusion parameters,there were no significant difference between the head and the tail of pancreas in either normal group or acute pancreatitis group（P＞0.05）.ConclusionThose CT perfusion parameters between two groups were statistically significant and the 64-slice spiral CT perfusion imaging can reflect the change of the blood flow for acute pancreatitis.It is valuable that 64-slice spiral CT perfusion technology can be used to diagnose acute pancreatitis.更多还原