孤立性肺结节CT灌注成像的研究  

The Study on CT Perfusion Imaging of Solitary Pulmonary Nodule

作　　者：王锋[1] 王藏海 吕国士[1] 梁建玲[3] 王德韧[1] 左宏[1] 云浩[1] 刘占标[1] 李志军[1] 

机构地区：[1]解放军251医院影像科,河北张家口075000 [2]河北省二医院放射科 [3]解放军251医院呼吸科,河北张家口075000

出　　处：《实用放射学杂志》2008年第4期479-482,573,共5页Journal of Practical Radiology

摘　　要：目的评价64排螺旋CT对孤立性肺结节的诊断价值。方法统计分析39例孤立性肺结节CT灌注函数和强化指标,包括血流量(BF),血容量(BV),渗透表面积乘积(PS),正增强积分(PEI),最大上升斜率(MST),最大下降斜率(MSD),病变强化值(PH),平均通过时间(MTT),至峰值时间(TTP)及结节与主动脉强化值比(R),并与病理结果进行对照。结果①恶性组的BF、BV、PS、PEI、MSI、MSD值均明显高于良性组(P<0.001),恶性组和良性组之间的MTT、TTP值无明显差别(P>0.05)。②良恶性病变组间的时间密度曲线(TDC)类型分布存在明显差异。③将BV、PS、PEI、R4个指标相结合进行Fisher’s线性判别分析,正确判别率达94.9%(37/39例)。结论VCT灌注指标BF,BV,PS,PH,R,PEI,MSI以及MSD有助于肺内良恶性病变的鉴别。Objective To assess the value of 64 - slice spiral CT perfusion imaging in diagnosing the solitary pulmonary nodules. Methods 39 cases with solitary pulmonary nodules underwent CT perfusion imaging,the perfusion parameters and enhanced indexes,including blood flow（BF） , blood volume { BV I , permeability surface area product （PSI , positive enhancement integral （PEI） , maximum slope of increase （MSI ） , maximum slope of decrease （MSD ） , peak height（PH ） , mean transit time （MTT ） , time to peak （ TTP ） and PHmass/PHaorta （ R） were analysed comparatively with pathology. Results ①The mean values of BF,BV,PS,PH,R,PEI,MSI and MSD in malignant group were significantly higher than those in the benign （ P 〈 0. 001 ）. No statistically significant differences in MTT, TTP was found between the malignant and the benign group （ P 〉 0.05） ②There were differences in the distribution of the time -density curve TDC I types between the two groups. ③In the Fisher＇ s linear discriminant analysis combination of BV, PS, PEI and R, the accuracy of diagnosis was 94.9% （37/39 cases）. Conclusion In CT perfusion imaging, the BF,BV, PS, PH,R,PEI, MSI and MSD can contribute to the discrimination of the benign from the malignant.

关 键 词：肺 孤立性肺结节 体层摄影术 X线计算机 灌注成像 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学]