肺孤立性病灶首过期CT灌注时间-密度曲线与血管生成关系的研究  

Study on the Relationship between the Time-Density Curve of MSCT Perfusion Imaging in First Pass Phase and Angiogenesis in Solitary Pulmonary Lesion

作　　者：邓东[1] 张小波[1] 龙莉玲[1] 黄仲奎[1] 秦宇红[1] 林盛才[1] 李春兰[1] 梁玉梅[1] 杨新官[1] 

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2009年第11期1571-1574,1578,共5页Journal of Practical Radiology

基　　金：基金项目：广西自然科学基金资助项目（编号：0832160）.

摘　　要：目的 分析比较肺孤立性病灶多层螺旋CT（MSCT）首过期灌注时间-密度曲线与血管生成的相关性。方法39例经手术病理证实的肺孤立性病灶患者术前行MSCT首过期灌注扫描，包括恶性病变25例，良性和炎性病变各7例。所得图像数据经计算机获得病灶感兴趣区（ROD的时间-密度曲线（TDC）。采用免疫组化方法测定病理标本的微血管密度（MVD）和检测血管内皮细胞生长因子（VEGF）表达，分析病灶TDC与MVD、VEGF的相关性。结果肺孤立性病灶不同类型之间的TDC曲线分布差异有统计学意义（P均〈O．05），恶性组25例均为TDC—A型曲线（25／25）；良性组7例多以TDC—C型为主（6／7）；炎性组7例既有TDc—A型（3／7）又有TDC—B型（4／7）。TDC—A型曲线和TDC—B型曲线的MVD计数、VEGF表达强度的差异元统计学意义（P〉0．05），但两者与TDC—C型之间的差异均有统计学意义（P均〈0．05）。结论MSCT首过期灌注扫描，有助于肺孤立性病灶的鉴别诊断；TDC能在一定程度上反映肺孤立性病灶的血管生成活性。Objective To analyze the relationship between the time-density curve （TDC） of MSCT perfusion imaging in first pass phase and angiogenesis in solitary pulmonary lesion. Methods 39 patients with solitary pulmonary lesions confirmed by pathology underwent MSCT perfusion scan before operation,including malignant lesions in 25, benign and inflammatory lesions in 7, respectively. All perfusion images were transferred to workstation,then the TDC were acquired in the regions of interest（ROI）. Microvessel density（MVD） and the VEGF expression were detected through immunohistochemistry. The correlation were analyzed between the type of TDC with MVD and VEGF. Results There were statistical differences in the distribution of the TDC types in different solitary pulmonary lesion（P〈0.05）. The TDC of malignant group were display as Type A（25/25）. Most of the TDC of benign group was Type C（6/7）. The TDC of inflammatory group appeared as Type 15（4/7） and Type A（3/7）. No statistically difference in MVD and VEGF was found between Type A and Type B（P〉0.05）, but there was statistically difference in MVD and VEGF between Type A and Type C or between Type C（P〈0.05）. Conclusion MSCT perfusion scan is helpful in distinguishing benign solitary pulmonary lesion from malignant one,and TDC can reflect angiogenesis activity of solitary pulmonary lesion in certain degree.

关 键 词：肺 肺孤立性病变 时间-密度曲线 体层摄影术 X线计算机 灌注成像 微血管密度 血管内皮细胞生长因子 

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