多层螺旋CT灌注成像在孤立性肺结节鉴别诊断中的应用  

Differential diagnosis of solitary pulmonary nodule: perfusion imaging with multi-slice spiral CT

作　　者：朱才松[1] 杨军[1] 吕琦[1] 邵康为[1] 刘伟[1] 肖正光[1] 

机构地区：[1]上海市长宁区中心医院影像科,200336

出　　处：《上海医学影像》2009年第3期204-208,共5页Shanghai Medical Imaging

基　　金：上海市卫生局重点专科基金资助(项目编号:05II025)

摘　　要：目的探讨多层螺旋CT灌注成像在孤立性肺结节(SPN)鉴别诊断中的应用价值。方法前瞻性研究99例直径2～4cm的孤立性肺结节的32层螺旋CT灌注表现,测定肺内病灶的血容积(BV)、表面通透性(PS)、血流量(BF)、平均通过时间(MTT)的数值,并在时间-密度曲线的基础上,测量SPN增强净增值(NE)和达峰时间(TTP);取值进行统计学分析。结果恶性、炎性BV值均明显高于良性(P<0.001,P<0.05),而恶性与炎性之间无统计学差异(P>0.05);PS值中,组间均有统计学差异(所有P<0.01)。BF值中,恶性结节>炎性结节>良性结节,MTT值三者接近;但BF值、MTT值组间均无统计学差异(P均>0.05)。恶性与炎性结节的TTP值之间有统计学差异(P<0.01)。NE值中,组间均有统计学差异(所有P<0.05)。良性、恶性及炎性结节的TDC形态不同。结论多层螺旋CT灌注成像技术有助于孤立性肺结节的鉴别诊断。Objective To evaluation the differential diagnostic ability of multi-slice spiral CT perfusion imaging in solitary pulmonary nodules（SPNs）. Methods A prospective study was undertaken in 99 patients with diameter of 2- 4cm of SPN using 32-slice spiral CT perfusion. The parameters of CT perfusion including blood volume （BV）, permeability surface （PS）, blood flow （BF）, mean transit time （MTT） were analyzed. The net enhancement （NE） and time to peak（TTP） of SPN were measured on time-density curve （TDC）. The data gathered from the average values were analyzed statistically. Results BV values of malignant and inflannnatory SPNs were significantly higher than that of benign（ P〈0.001, P〈0.05）, with no significant difference between that of malignant and active inflammatory SPNs （P〉0.05）. There were statistic significant differences in PS values between the two groups （ all P〈0.05）. BF values of malignant and active inflammatory showed higher than that of benign SPNs, MTT showed approach among them, with no significant differences in BF and MTT values between the two groups （ all P〉0.05）. The difference of TTP was statistically significant between malignant and inflammatory SPNs（P〈0.01）. There were statistic significant difference in NE between the two groups （all P〈0.05）. The TDC appeared different for the three groups. Conclusion It is helpful to differential diagnosis of SPNs with 32-slice spiral CT perfusion imaging.

关 键 词：孤立性肺结节 灌注成像 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]