多层CT灌注成像在肺内肿瘤诊断中的应用  

The Application of Multi-slice CT Perfusion Imaging in Diagnosing Pulmonary Neoplasms

作　　者：周漠玲[1] 刘进康[1] 熊曾[1] 朱智明[1] 陈伟[1] 

机构地区：[1]中南大学湘雅医院放射科,湖南长沙410008

出　　处：《实用放射学杂志》2008年第9期1194-1198,共5页Journal of Practical Radiology

摘　　要：目的研究16层螺旋CT灌注成像在鉴别肺内肿瘤中的价值。方法对63例肺部单发病变进行前瞻性分析,采用Philips Brilliance16排螺旋CT对肿块行灌注扫描。用CT灌注软件包进行分析。结果高及中分化组的灌注值(PV),最高增强值(PE)及血容量(BV)值明显高于低分化及未分化组肺癌,差异均有统计学意义(分别为P<0.01,P<0.01,P<0.05)。肺部病变PV、PE、BV值为炎性>恶性>良性,其中PV、PE值各组间差异均有统计学意义,而BV值仅炎性病变与良性病变之间差异有统计学意义(P<0.01);如果以15<PV≤60ml.100g-1.min-1且同时8<PE≤30HU作为恶性指标时,其对恶性病变的诊断准确率最高,为90.5%。肺鳞癌与腺癌的PV、PE、达峰值时间(TTP)、BV值差异无统计学意义(P>0.05)。中央型与周围型肺癌各灌注参数也无统计学意义(P>0.05)。结论螺旋CT灌注成像对鉴别肺内恶性、良性及炎性病变及判别肺癌恶性程度有较大价值。Objective To evaluate the value of Multi - slices CT perfusion imaging in differentiating pulmonary nodules. Methods A prospective study was undertaken in sixty - three patients with pulmonary neoplasms. The patients were underwent perfusion imaging with Philips Brilliance16 - slice helical CT , The images were analysed using perfusion software. Results Well and moderate differentiating lung carcinomas had a significantly higher perfusion value（PV） ,peak enhancement（PE） and blood volume（BV） value than poorly differentiating and small cell ones. The differences were all statistically significant （ P 〈 0. 01 ,P 〈 0. 01 ,P 〈 0.05 ）. The PV,PE and BV value in pulmonary lesions exhibited inflammatory 〉 malignant 〉 benign,of which,there were significan differences in PV and PE value between any two of the three lesions. There were significant differences in BV value only between benign and inflammatory pulmonary lesions （P 〈 0.01 ）. When 15 〈 PV≤60 ml · 100 g^-1· min ^-1 and 8 〈 PE≤30 HU were set as the diagnostic threshold in malignant lesions, the accuracy was 90.5%. There were no significant differences in PV,TTP, BV and PE between squamous cell carcinomas and adenocarcinoma, and between peripheral carcinomas and central ones too（ P 〉 0. 05 ）. Conclusion CT perfusion imaging is of important value in differentiating inflammatory,malignant and benign masses of the lung and estimating the degree of malignancy of lung cancer.

关 键 词：肺 灌注成像 肿瘤 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]