肾上腺多层CT灌注成像的临床应用研究  

Clinical Study of Adrenal Multi-slice CT Perfusion Imaging

作　　者：乔中伟[1,2] 缪飞[1] 朱延波[1] 李卫侠[1] 施卫平[1] 董海鹏[1] 吴志远[1] 徐学勤[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科 [2]复旦大学附属儿科医院放射科

出　　处：《中国医学计算机成像杂志》2008年第5期420-424,共5页Chinese Computed Medical Imaging

基　　金：上海市科技委员会资助项目(编号044119714)~~

摘　　要：目的:研究肾上腺多层CT灌注成像对于肾上腺病变鉴别诊断的应用价值和病理基础。材料和方法:回顾性研究一组肾上腺病变的多层CT灌注成像,GE ADW4.2后处理工作站计算其灌注参数,包括血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS),并与临床实验室资料和病理结果对照。结果:嗜铬细胞瘤BF和PS明显大于肾上腺腺瘤、肾上腺增生、结核、淋巴瘤和转移瘤。恶性嗜铬细胞瘤PS高于良性嗜铬细胞瘤。肾上腺增生、功能性腺瘤和嗜铬细胞瘤等功能性肾上腺病变的BF、BV和PS高于肾上腺淋巴瘤、结核和转移瘤等功能下降的肾上腺病变。富脂类腺瘤和乏脂类腺瘤的灌注参数无明显差异。肾上腺病变的灌注参数和微血管密度表达有关。结论:多层CT灌注成像反映了肾上腺微血管状况,灌注参数的差异可作为肾上腺病变鉴别诊断的辅助方法。PS值的差异可能有助于良恶性嗜铬细胞瘤的鉴别。Purpose： To study the value of multi - slice CT perfusion in differential diagnosis of adrenal lesions and the pathological basis. Materials and Methods： A retrospective study of adrenal lesions underwent MSCT perfnsion scan. The CT perfusion parameters , including blood flow （BF）, blood volume （BV）, mean transit time （MTT）, permeability surface （PS） were analyzed, and the correlation between the parameters and clinic, pathological factors were studied. Results： BF and PS of pheochromocytoma （PCC） were higher than those of adrenal adenoma, adrenal hyperplasia, adrenal tuberculosis, lymphoma and metastasis. Malignant PCC had a higher PS than benign PCC. Tuberculosis, lymphoma and metastasis which had adrenal hypofunction had lower BF, BV, PS than adrenal lesions which had hyperfunction. No difference of BF, BV, MTT and PS between lipid- rich and lipid - poor adenoma. The perfusion parameters were associated with the microvessel density （MVD） of adrenal lesions. Conclusion： MSCT perfusion imaging which may reflect blood flow and MVD of adrenal lesions has potential value of clinical application to differentiating adrenal lesions. PS would be helpful to distinguish benign or malignant PCC.

关 键 词：肾上腺 体层摄影术 X线计算机 灌注成像 

分 类 号：R816.6[医药卫生—放射医学]