颈部淋巴结病变的CT灌注成像研究  

CT perfusion study of neck lymph nodes

作　　者：钟进[1] 刘筠[1] 华锐[1] 乔辉[1] 宫毅[1] 

机构地区：[1]天津市人民医院影像学部,300121

出　　处：《中华放射学杂志》2011年第1期46-49,共4页Chinese Journal of Radiology

基　　金：天津市卫生局基金资助项目（05KYR03）

摘　　要：目的 分析不同病理类型颈部淋巴结的CT灌注特点及鉴别诊断价值。方法对83个经病理证实的淋巴结结核、淋巴瘤及肿瘤转移性淋巴结行多层螺旋CT灌注扫描，比较其形态学、血流方式及灌注参数等方面的差异性。3组间灌注参数及淋巴结的长径／横径（L／T）比较采用单因素方差分析和LSD检验。结果淋巴结结核、淋巴瘤及肿瘤转移性淋巴结3组的平均通过时间（MTT）分别为（28．13±5．08）、（31．08±5．82）、（11．24±5．31）S，肿瘤转移性淋巴结的M＇IT值低于淋巴结结核、淋巴瘤（P值均〈0．05）。3组病变边缘型血流的出现率分别为5／9、4／19、39／55（70．9％），淋巴结结核、转移性淋巴结边缘型血流的出现率高于淋巴瘤（P值均〈0．05）；3组中心型血流的出现率分别为2／9、11／19、9／55（16．4％），淋巴瘤中心型血流的出现率高于肿瘤转移性淋巴结和淋巴结结核（P值均〈0．05）；3组淋巴结的L／T分别为1．82±0．32、1．80±0．39、1．84±0．36；血流量（BF）分别为（34．23±5．96）、（34．00±6．88）、（35．62±10．84）ml·min^-1·100g^-1；血容量（Bv）分别为（24．68±2．84）、（25．30±3．16）、（25．15±8．81）ml·100g^-1；达峰时间（TTP）分别为（40．90±8．85）、（40．67±6．45）、（40．98±6．62）s；上述各参数比较差异均无统计学意义（P值均〉0．05）。结论应用CT灌注成像技术，把功能性成像与灌注血流图相结合可全面、客观地对病变做出诊断。Objective To study the CT perfusion features of various lymph nodes in the neck. Methods Dynamic perfusion CT scanning was performed in 83 neck lymph nodes proved by pathology, including tuberculosis lymph nodes, lymphoma and metastatic lymph nodes. The shapes, blood flow modes, and perfusion parameters of these lymph nodes were compared among 3 groups. Statistical analysis of L/T and CT perfusion parameters was performed by one-way ANOVA and LSD test. Results The values of MTT of tuberculosis lymph nodes, lymphoma and metastatic lymph nodes were （28.13 ±5.08）, （31.08±5.82）, and （ 11.24± 5.31 ） s, respectively. The MTT of metastatic lymph nodes was statistically lower than that of tuberculosis lymph nodes and lymphoma （P 〈 0. 05 ）. Their frequencies of marginal blood flow were 5/9, 4/19, and 39/55（70. 9% ）, respectively. The frequency of marginal blood flow in the tuberculosis lymph nodes and metastatic lymph nodes was statistically higher than that of lymphoma （ P 〈 0. 05 ） . Their frequencies of central blood flow were 2/9, 11/19, and 9/55 （ 16. 4% ） , respectively. The frequency of central blood flow in the lymphoma was statistically higher than that of tuberculosis lymph nodes and metastatic lymph nodes（P 〈0. 05）. Their values of L/T were 1.82 ±0. 32, 1.80±0. 39, and 1.84±0. 36, respectively. The values of BF were （34.23±5.96）, （34.00 ±6.88）, and （35.62±10.84） ml · min^1 . 100 g^-1 ,respectively. The values of BV were （24.68 ± 2. 84 ） , （25.30 ± 3.16 ） , and （25.15 ±8.81） ml ·100 g-l,respectively. The values of The were （40.90 ±8.85）, （40.67 ±6.45）, and （40.98±6.62） s, respectively. There were no significant differences in L/T, BF, BV and TIP among tuberculosis lymph nodes, lymphoma and metastatic lymph nodes （ P 〉 0. 05 ）. Conclusion CT perfusion, especially combination functional imaging with perfusion images may be helpful in judging the nature of neck lymph nodes.

关 键 词：淋巴结 体层摄影术 X线计算机 

分 类 号：R445.1[医药卫生—影像医学与核医学]