CT灌注成像在腮腺肿瘤鉴别诊断中的临床价值  

Clinical value of CT perfusion in the differentia; diagnosis of parotid gland tumors

作　　者：范卫君[1] 吕衍春[1] 肖鹏[1] 张亮[1] 沈静娴[1] 李旺[1] 

机构地区：[1]中山大学肿瘤防治中心影像介入中心,广州510060

出　　处：《中华放射学杂志》2007年第9期921-925,共5页Chinese Journal of Radiology

摘　　要：目的探讨多层螺旋 CT 灌注成像技术定量评价腮腺良、恶性肿瘤的血液动力学特点及其对腮腺良恶性肿瘤的鉴别诊断价值。方法 53例患者共57个病变,其中良性肿瘤35例,恶性肿瘤18例,全部经术后病理证实。术前行 CT 灌注检查。采用 Philips perfusion 功能软件包获取组织的时间密度曲线(time density curve,TDC)及 CT 灌注参数,包括灌注量、增强峰值(PH)、达峰时间(TTP)、血容量(BV)、平均通过时间(MTT)。采用 Wilcoxon 符号秩和检验进行统计学处理。结果腮腺良性肿瘤的 CT 灌注参数的中位数及四分位间距[25% CI 75%(Q_1,Q_2)]分别为:灌注量73.5(18.7,113.3)ml·100g^(-1)·min^(-1)、PH 34.5(17.7,53.1)HU、TTP 20.0(13.6,34.4)s、BV 38.5(29.1,63.3)ml·100 g^(-1)、MTT 7.6(4.5,28.7)s。腮腺恶性肿瘤的 CT 灌注参数分别为:灌注量135.9(101.4,195.2)ml·100 g^(-1)·min^(-1),PH 49.1(32.7,59.4)HU,TTP 12.9(11.3,14.6)s,BV 67.5(52.4,109.5)ml·100 g^(-1),MTT 6.0(5.1,7.6)s。统计结果显示,CT 灌注参数 BF、BV、TTP 的中位数及四分位间距在腮腺良恶性肿瘤之间差异具有统计学意义(P 值均<0.05),而 PH、及 MTT 之间差异无统计学意义(P>0.05);腺淋巴瘤、其他良性肿瘤、恶性肿瘤的 TDC 的差异也有统计学意义(P 值均 <0.05)。结论 CT 灌注扫描技术对腮腺良恶性肿瘤的鉴别诊断具有一定价值。Objective To explore the usefulness of CT perfusion imaging in quantitatively judging the blood patterns of the benign tumors and the malignancies of the parotid, and to evaluate its clinical value in differentiating benign tumors from malignant tumors of the parotid. Methods Fifty-three patients were included in this study （35 with benign tumors and 18 with malignant tumors）. All the tumors were confirmed histopathologically and examined with CT perfusion before operations. The parameters of CT perfusion were obtained by using PHILIPS perfusion software, including time-density curve （TDC）, perfusion （ml · 100g^-1 · min^-1）, peak height （PH： HU）, time to peak （TTP： s）, blood volume （BV： ml · 100 g^-1 ）, and mean transit time （ MTT： s ）. Wilcoxon signed-rank test for paired data were used to determine the statistical differences of parameters between the benign and malignant tumors. Rsults The median and quartile range of Perfusion, PH, TTP, BV, MTT were 73.5 ml · 100 g^-1·min^-1, （ 18.7,113. 3）, 34.5 HU,（17.7,53.1）,20.0 s,（13.6,34.4）, 38.5 ml · 100 g^-1, （29. 1,63.3） ,7.6 s, （4.5,28.7） respectively in benign tumors, versus 135.9 ml · 100 g^-1·min^-1, （101.4,195.2） ,49. 1 HU, （32.7, 59.4） ,12.9 s,（11.3,14.6）,67.5 ml · 100 g^-1 ,（52.4,109.5） ,6.0 s,（5.1,7.6） in malignant tumors. Except for PH, MTT, the difference of perfusion, TTP and BV between benign and malignant tumors were statistically significant（ P 〈0.05 ） ,The difference of TDC among the Warthin＇s tumor, other benign tumors, and malignant tumors was also statistically significant （ P 〈 0. 05 ）. Conclusions On the basis of this study, the parameters of CT perfusion, BF, BV and TDC were valuable in differentiating benign and malignant tumors of the parotid gland.

关 键 词：腮腺肿瘤 体层摄影术 X线计算机 病理学 

分 类 号：R739.8[医药卫生—肿瘤]