目的 探讨CT灌注成像(CTP)对 非小细胞肺癌(NSCLC)放疗疗效的评估价 值。方法 收集经病理证实并行放疗治疗 NSCLC患者90例，分别于放疗前后行CTP检 查，获取肿瘤区CTP参数血容量(BV)、血 流量(BF)；比较NSCLC放疗前后BV、BF变 化，并应用ROC曲线分析BV值降低率、BF 值降低率对NSCLC放疗疗效的评价效能。 结果 90例患者，放疗治疗后，CR 0例， PR 46例，SD 37例，PD 7例，缓解率为 51.11%(46/90)；NSCLC放疗后BV、BF值较 放疗前均明显降低(P<0.05)。与非缓解组 相比，放疗后缓解组BV值降低率、BF值降 低率均明显增大(P<0.05)。ROC曲线分析 显示，以BV值降低率=43.20%、BF降低值 率=16.50%为截断值评价NSCLC放疗缓解的 效能最佳，ROC曲线面积分别为0.839、 0.811，相应敏感度、特异度、准确度分 别为82.61%、88.64%、85.56%和80.43%、 84.09%、82.22%。结论 CTP参数BV、BF 值降低率可作为NSCLC放疗疗效的评价指 标。

Objective To explore the value of CT perfusion imaging (CTP) in evaluating the curative effect of radiotherapy for non-small cell lung cancer (NSCLC). Methods Ninety-six patients with pathologically confirmed NSCLC who underwent radiotherapy were selected. CTP was performed before and after radiotherapy to obtain CTP parameters blood volume (BV) and blood flow (BF) in the tumor area. The changes of BV and BF before and after radiotherapy were compared. The ROC curve was used to analyze the efficiencies of the reduction rate of BV and the reduction rate of BF for evaluation of the curative effect of radiotherapy. Results Among the 90 patients, there was no patient with CR, 46 patients with PR, 37 patients with SD and 7 patients with PD after radiotherapy, and the remission rate was 51.11% (46/90). The BV and BF were significantly decreased after radiotherapy (P<0.05). Compared with the non-remission group, the reduction rates of BV and BF were significantly higher in the remission group after radiotherapy (P<0.05). ROC curve analysis showed that the efficiencies of reduction rates of BV and BF (43.20% and 16.50%) were the best for evaluation of the curative effect of radiotherapy. The areas under ROC curve were 0.839 and 0.811. The corresponding sensitivities, specificities and accuracy rates were 82.61%, 88.64%, 85.56% and 80.43%, 84.09% and 82.22%, respectively. Conclusion CTP parameters, namely the reduction rates of BV and BF can be used as evaluation indexes for the curative effect of radiotherapy for NSCLC.