多层螺旋CT动态增强评价明显强化孤立肺结节血流模式技术  

Dynamic enhanced multi-slice spiral CT in the evaluation of blood flow patterns of solitary pulmonary nodules

作　　者：李慎江[1] 肖湘生[1] 李惠民[1] 刘士远[1] 李成洲[1] 张沉石[1] 陶志伟[1] 杨春山[1] 

机构地区：[1]第二军医大学附属长征医院放射科,上海200003

出　　处：《放射学实践》2004年第10期718-722,共5页Radiologic Practice

摘　　要：目的 :探讨多层螺旋CT(MSCT)动态增强评价明显强化孤立肺结节血流模式的技术。方法 :78例明显强化孤立肺结节患者 ,结节直径≤ 4cm ,其中恶性病变 68例 ,活动性炎症 10例。增强前、后采用MarconiMx 80 0 0MSCT扫描 ,以 4ml/s的流率从肘静脉注入非离子型对比剂 ,动态扫描选择肺结节最大层面进行。其中 40例 15～ 45s、75～ 10 5s时 ,每 2秒扫描一次 (程序 1) ;3 8例 11～ 41s、71～ 10 1s时 ,每 2秒扫描一次 (程序 2 ) ;两组患者在第 2～ 9min时段内间隔 3 0s扫描一次。病灶直径 3～ 4cm时 ,扫描层厚 5mm ;病灶直径≤ 3cm时 ,扫描层厚 2 .5mm ,以常规算法重建图像。记录孤立肺结节增强前后各时相的CT值并计算强化值、灌注值、结节 主动脉强化值比、平均通过时间。结果 :程序 1与程序 2所得恶性结节强化值 (t=0 .673 ,P >0 .0 5 )、灌注值 (t=0 .15 2 ,P >0 .0 5 )、结节 主动脉强化值比 (t =0 .861,P >0 .0 5 )、平均通过时间 (t=0 .199,P >0 .0 5 )均无统计学差异。程序 1只得到了部分患者 ( 2 5 /3 2 )的结节平均通过时间 ;程序 2得到了全部患者 ( 3 6/3 6)的结节平均通过时间。结论 :MSCT动态增强评价明显强化孤立肺结节血流模式 ,第一次扫描时间拟选在Objective:To investigate the methods of dynamic enhanced multi-slice spiral CT in the evaluation of blood flow patterns of solitary pulmonary nodules (SPNs) with enhancement.Methods:78 patients with solitary pulmonary nodules (SPNs with strong enhancement) (≤4cm) underwent dynamic multi-slice spiral CT scan (Marconi Mx 8000) before and after contrast enhancement that was accomplished by injecting contrast material with a rate 4ml/s.For the 40 patients in protocol Ⅰ,one scan was obtained every 2s during 15～45s and 75～105s after injection,while for the 38 patients in protocol Ⅱ,one scan was obtained every 2s during 11～41s and 71～101s.For all the patients,one scan was obtained every 30s during 2～9min.The section thickness was 2.5mm for lesions less than 3cm and 5mm for lesions between 3 to 4cm.Standard algorithm was used in the image reconstruction.Precontrast and postcontrast attenuation on every scan was recorded.The perfusion,peak height,ratio of peak height of the SPN to that of the aorta and mean transit time were calculated. Results:No statistically significant differences were found between the peak height(t=0.673,P>0.05),perfusion (t= 0.152,P>0.05),ratio of peak height of the SPN to that of the aorta(t=0.861,P>0.05) and mean transit time (t=0.199,P>0.05)in malignant solitary pulmonary nodules measured in protocol Ⅰ and those measured in protocol Ⅱ.The mean transit time could be determined with protocol Ⅱ in all patients (36/36),but in only part of patients (25/32) with protocol Ⅰ.Conclusion:Dynamic enhanced multi-slice spiral CT is a kind of non-invasive methods for quantitative evaluation of blood flow patterns of solitary pulmonary nodules with enhancement and scans beginning at 11s after injection of contrast material is suggested.

关 键 词：体层摄影术 X线计算机 孤立性肺结节 血流动力学 

分 类 号：R816.4[医药卫生—放射医学]