medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.medvis-26Research ArticleБРЮШНАЯ ПОЛОСТЬABDOMENДинамическая компьютерная томография у больных раком поджелудочной железы. Оценка перфузии в опухоли и в паренхиме железы вне ееDynamic Computed Tomography at Patients with Pancreatic Cancer. Perfusion Analysis in the Tumor and Pancreatic ParenchymaНестеровДенис ВалерьевичNesterovDenis Valerievichcireto@gmail.comРозенгаузЕвгений ВладимировичRozengauzEvgenij Vladimirovichnoemail@neicon.ruГБОУ ВПО “Российский научный центр радиологии и хирургических технологий”РоссияRussian Scientific Center of Radiology and Surgical TechnologiesRussian FederationГБОУ ВПО “Российский научный центр радиологии и хирургических технологий”; ГБОУ ВПО “Северо-Западный государственный медицинский университет им. И.И. Мечникова”РоссияRussian Scientific Center of Radiology and Surgical Technologies; I.I. Mechnikov North-Western State Medical UniversityRussian Federation201428042014026874Copyright © Нестеров Д.В., Розенгауз Е.В., 20142014Нестеров Д.В., Розенгауз Е.В.Nesterov D.V., Rozengauz E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/26

Цель: оценить характер КТ-перфузии аденокарциномы и паренхимы поджелудочной железы (ПЖ) вне видимых границ опухоли. Материал и методы. В исследование вошло 37 человек: 12 (32,4%) пациентов с гистологически верифицированной аденокарциномой ПЖ и 25 (67,6%) без патологии ПЖ. Перфузионную КТ выполняли на 320-срезовом компьютерном томографе. Расчет перфузионных показателей производили с помощью метода максимального градиента. Результаты. В норме скорость кровотока (СК) в различных анатомических частях ПЖ статистически значимо не различалась. Средняя СК в визуально не измененной паренхиме ПЖ составила 115 ± 34 мл/100 мл/ мин и не различалась у пациентов с опухолью и без. СК в опухоли составляла 64 ± 32 мл/100 мл/мин и была статистически значимо ниже по сравнению с неизмененной паренхимой ПЖ. Анализ связи между СК участков опухоли и расстоянием от края опухоли показал, что в опухоли можно выделить три зоны: периферическую зону снижения СК, не зависящую от глубины залегания зоны интереса, зону центрипетального снижения СК и центральную зону, где СК снижена в наибольшей степени и не коррелирует с глубиной залегания зоны интереса. Выводы. Перфузионная КТ может служить дополнительным методом исследования, расширяющим возможности визуализации опухоли и понимания патогенетических механизмов ее развития.

The aim was to analyze CT-perfusion of adenocarcinoma and pancreatic parenchyma outside the tumor. Material and methods. We examined 12 patients with histologically verificated pancreatic adenocarcinoma and 25 patients that hasn’t any pathology of pancreas. Perfusion CT was performed at 320-slice CT. Perfusion parameters were calculated with maximum slope method. Results. There were no significant differences found between perfusion characteristics of pancreatic head, body and tail. Also, we didn’t found significant differences in perfusion of visually not altered pancreatic parenchyma between patients with tumor and patients without any pathology of the pancreas. Perfusion of tumor was significantly lower than perfusion of visually not altered pancreas (64 ± 32 vs 115 ± 34 ml/100 ml/min; p < 0.05). Accordingly to perfusion changes tumor can be divided into three parts: superficial zone of decreased blood flow not correlating with the distance from tumor border, zone where we can see gradual centripetal decreasing of blood flow and central zone of the most altered perfusion without centripetal decreasing of blood flow. Conclusion. With PCT we can get additional characteristics of tumor which can be helpful in understanding of tumor pathogenesis.

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The authors declare that there are no conflicts of interest present.