肺孤立性球形病变的64层CT灌注研究  

Perfusion imaging with 64-slice CT in the study of solitary pulmonary spherical lesions

作　　者：张庆华[1] 胡春洪[2] 顾光官[1] 

机构地区：[1]无锡市中医医院放射科,江苏214001 [2]苏州大学附属第一医院影像中心,江苏215006

出　　处：《放射学实践》2010年第11期1220-1223,共4页Radiologic Practice

摘　　要：目的:探讨肺部孤立性球形病变CT灌注成像(CTPI)参数定量分析的诊断价值。方法:57例孤立性肺部球形病变分成3组:恶性肿瘤组共37例,包括腺癌18例、鳞癌4例、腺鳞癌5例、肺泡细胞癌4例、大细胞癌3例、小细胞癌及血管外皮瘤各1例,1例临床发现其它部位出现转移灶考虑为恶性病变;良性肿瘤组共11例,包括硬化性血管瘤5例、结核瘤4例、腺瘤2例;炎性病变组共9例,包括炎性假瘤4例、活动性结核2例、炎性肉芽肿3例。使用64层CT机行CTPI分析。所得原始数据传至Syngo工作站行后处理,得到CTPI图并测量病变的BF、BV、PS和MTT等灌注参数值。结果:良性肿瘤组、恶性肿瘤组及炎性病变组的BF值分别为(34.95±16.40)、(62.53±22.22)和(74.34±13.98)ml/(100ml.min),BV值为(5.51±2.59)(、11.29±5.72)和(9.62±1.55)ml/100ml,PS值为(19.90±4.22)、(39.13±12.93)和(24.05±5.47)ml/(100ml.min),MTT值为(9.52±2.72)、(9.84±4.83)和(7.25±1.30)s。良性、恶性肿瘤组BF、BV及PS值差异均有显著性意义(P<0.01),以BF≥55ml/(100ml.min)、BV≥6ml/100ml且PS≥23ml/(100ml.min)为诊断阈值,诊断恶性病变的敏感度为97.3%、特异度为94.6%;炎性病变组和良性肿瘤组间BF、BV值差异有显著性意义(P<0.01),PS值差异无显著性意义(P>0.05),以BF≥55ml/(100ml.min)且BV≥6ml/100ml为诊断阈值,诊断敏感度为90.9%、特异度为89.9%;恶性肿瘤组和炎性病变组间BF、BV值差异无显著性意义(P>0.05),PS值差异有显著性意义(P<0.01),以PS≥23ml/(100ml.min)为诊断阈值,其敏感度为93.6%,特异度为90.2%;MTT值在3组病变间差异均无显著性意义(P>0.05)。结论:64层CTPI能够客观评价肺部球形病变的血流动力学状况;灌注参数BF、BV及PS对肺部球形病变具有不同的诊断效能,综合分析各参数值可提高诊断效能。Objective： To study the value of quantitative analysis of the parameters with CT perfusion imaging （CTPI） in the diagnosis of solitary pulmonary spherical lesions. Methods： Fifty-seven eases of solitary pulmonary spherical lesions were divided into three groups including malignant neoplasm （37 cases, with adenocarcinoma, n= 18 ＇ squamous carcinoma, n =4;adenosquamous carcinoma,n 5;alveolar cell carcinoma,n=4;large cell carcinoma,n=3;small cell carcinoma,hemangiopericytoma for 1 ease each and I case considered as malignant tumor due to metastases in other parts of the body） ;benign mass （1] cases,with sclerosing hemangioma,n=5;tubereuloma,n=4;adenoma,n 2） ;and inflammatory masses （9 cases, with inflammatory pseudotumor,n=4;active tuberculosis,n=3;inflammatory granuloma,n=3）. All of the patients under went CTPI,and all of the raw data were post-proeessed with Syngo workstation and CTPI maps were obtained,parameters including BF （blood flow）,BV （blood volume）,PS （surface permeability） and MTT （mean transit time） were measured. Results：The BF value for benign mass, malignant neoplasm and inflammatory lesion group was （34.95 ± 16.40）, （62.53±22.22）,（74. 34± 13. 98）ml/（100ml · min） respectively;the BV value was （5. 51±2. 59）,11. 29±5. 72）, （9. 62± 1.55）ml/100ml respectlvely;the PS value was （19.90±4.22）, （39.13±12.93）,（24.05±5.47） ml/（100ml · min） respectively,and the MTT was （9.52±2.72）, （9.84±4.83）, （7.25± 1.30）s respectively. The differences of BF,BV,PS between malignant and benign group were statistically significant （P〈0. 01） ,taking BF≥55, BV≥6 and PS≥23 as the diagnostic threshold of malignant neoplasm,the sensitivity was 97.3% and the specificity was 94.6%. The differences of BF,BV between inflammatory and benign group were statistically significant （P〈0.01）,yet no significant difference was existed on PS （P〉0.05）. With BF≥55 and BV≥6 as the diagnostic threshold, the sensitivit

关 键 词：体层摄影术 X线计算机 灌注成像 肺肿瘤 

分 类 号：R816.4[医药卫生—放射医学]