颈部恶性淋巴结的多层螺旋CT灌注研究  

A perfusion study of malignant lymph nodes in the neck with multi-slice spiral CT

作　　者：梁颖[1] 罗德红[1] 吴宁[1] 李琳[1] 赵心明[1] 蒋力明[1] 黄遥[1] 蒋玲霞[1] 王建卫[1] 孙伟[1] 刘媛[1] 周纯武[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院影像诊断科

出　　处：《中华放射学杂志》2004年第11期1193-1197,共5页Chinese Journal of Radiology

摘　　要：目的　分析颈部不同病理类型恶性淋巴结的动态强化特点和CT灌注参数 ,探讨其在颈部肿瘤中的鉴别诊断价值。方法　对 5 0例颈部间隙肿瘤患者行CT动态扫描 ,盲法分析不同病理类型的 33例恶性淋巴结的时间密度曲线特点和灌注参数 ,比较它们在时间密度曲线和灌注参数方面差异。结果　恶性淋巴结的血流量 (BF)值、血容量 (BV)值和表面通透性 (PS)值高于正常组织 (P <0 0 5 ) ,MTT值短于正常组织 (P <0 0 5 )。鳞癌、甲状腺癌转移淋巴结和淋巴瘤的峰值、强化值、BF值和BV值不同 (P <0 0 5 )。峰值时间、MTT值和PS值方面 ,三者有差异 ,但差异无显著性意义 (P >0 0 5 )。结论　颈部恶性淋巴结与正常组织以及不同病理类型恶性淋巴结的灌注特点不同 ,BF值、BV值、MTT值和PS值有助于恶性淋巴结与正常组织鉴别 ,峰值、强化值、BF值和BV值可帮助鉴别不同病理类型的恶性淋巴结。Objective To study the imaging features of various malignant lymph nodes in the neck space by using time-attenuation curves (TAC) and CT perfusion parameters, and to explore their values in the differential diagnosis.Methods Dynamic enhanced CT scanning was performed in 50 patients with neoplasm in neck space, 33 of which were pathologically-proved malignant lymph nodes, including squamous carcinoma (n=16), thyroid carcinoma (n=8), and lymphoma (n=9). The data of TAC and perfusion parameters (BF, BV, MTT, and PS) of the neoplasms were recorded and analyzed statistically.Results Significant difference in BF, BV, MTT and PS existed between the malignant lymph nodes (319.26 ml·min -1·100 g -1, 7.68 ml·100 g -1, 2.91 s, and 44.69 ml·min -1·100 g -1) and normal tissue (P<0.05). The peak height, enhanced value, BF, and BV were statistically different among squamous carcinoma, thyroid carcinoma and lymphoma (P<0.05). The peak height, enhanced value, BF, and BV of thyroid carcinoma (104.65 HU、64.55 HU、770.18 ml·min -1·100 g -1, and 25.82 ml·100 g -1) were statistically higher than those of squamous carcinoma and lymphoma (P<0.05). BF of squamous carcinoma (312.94 ml·min -1·100 g -1) was higher statistically than that of lymphoma (231.14 ml·min -1·100 g -1) (P<0.05).Conclusion The TAC and perfusion parameters of malignant lymph nodes in squamous carcinoma, thyroid carcinoma, and lymphoma have different characteristics, and they are helpful in the differential diagnoses.

关 键 词：恶性 淋巴结 灌注 正常组织 颈部 病理类型 BV 动态扫描 峰值 参数 

分 类 号：R730.4[医药卫生—肿瘤]