64层容积CT肺灌注引导经皮肺活检术的应用研究  

Utility of GE 64-slice VCT perfusion in CT-guided percutaneous transthoracic biopsy of lung

作　　者：杜艳萍[1] 江兴堂[1] 康江河[1] 黄益民[1] 张其清[1] 

机构地区：[1]厦门大学附属中山医院福建医科大学教学医院呼吸科,福建厦门361004

出　　处：《临床内科杂志》2009年第2期104-106,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨64层容积CT肺灌注成像在引导经皮肺活检中的应用价值。方法前瞻性研究68例直径3～8cm肺肿块的64层容积CT灌注表现。将主动脉第一时相肺肿块的64层容积CT灌注成像各指标与肺肿块的病理结果进行对照分析。CT灌注成像3软件分析测量肿块的血流量（BF值）、血容量（BV）、平均通过时间（MTT）、毛细血管表面通透性（PS）。在BV图灌注最丰富的肿块部位取活检2～3块定为高灌注组，在BV图灌注欠丰富的肿物部位同时避开没有血供的钙化和坏死区取活检2～3块定为低灌注组。结果高灌注组经皮肺活检的阳性率和最终诊断符合率均明显高于低灌注组（P〈0．05）。良、恶性肿块的BV值、PS值和MTT值差异有统计学意义（P〈0．05），BF值差异无统计学意义（P〉0．05）。结论多层容积CT灌注对肺肿块的良、恶性鉴别诊断有较大的帮助，能提高经皮肺活检的最终诊断符合率。Objective To evaluate the clinical value of 64-slice VCT perfusion in CT-guided percutaneous transthoracic biopsy of lung. Methods A prospective study was undertaken in 68 patients with pulmonary masses whose diameter vary from 3 cm to 8 cm. We study these patients＇ CT-perfusion imaging of lung. Compare CT perfusion parameter with histopathogy of pulmonary masses, depend on the first-phase of contrast medium flew through aorta. Pulmonary masses were analyzed by the CT perfusion-3 body tumor software, the parameters of CT perfusion including blood flow（BF） , blood volume（BV） , mean transit time （MTT） and permeability surface（PS）. We biopsied 2 to 3 specimens where CT perfusion show high level of BV parameter and named it high perfusion group. We biopsied 2 to 3 specimens where CT perfusion show low level of BV parameter and named it low perfusion group. Results There is a high diagnostic accurate rate in high perfusion group than low perfusion group in CT-guided percutaneous transthoraeic biopsy（P 〈 0.05 ）. The difference of BV, PS and MTT were statistically significant between lung cancer to benign masses （P 〈 0.05 ）. There was no significant difference in BF between lung cancer to benign masses （P 〉 0.05 ）. Conclusion It is helpful to differentiate lung cancer from pulmonary benign masses with VCT perfusion imaging. VCT perfusion used in CT-guided percutaneous needle biopsy has a higher diagnostic accurate rate.

关 键 词：肿块 肺活检 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] R816[医药卫生—内科学]