CT灌注成像在预判肺癌组织类型中的应用  

Predicting the Histological Types of Lung Cancer with CT Perfusion Imaging

作　　者：徐列印[1] 文智[1] 马继文[1] 

机构地区：[1]新疆医科大学附属肿瘤医院CT室,新疆乌鲁木齐830011

出　　处：《实用放射学杂志》2011年第2期198-201,共4页Journal of Practical Radiology

摘　　要：目的分析肺癌的灌注特点，以期了解肺癌不同组织类型血供情况和提高肺癌组织类型的预判力。方法对临床怀疑肺癌患者37例行胸部常规加灌注扫描，数据经灌注软件处理，输出兴趣区时间密度曲线、灌注参数及对应伪彩图。对不同组织类璎肺癌的灌注参数进行统计分析。结果37例肺癌患者，经病理确诊鳞癌16例、腺癌15例、小细胞肺癌6例。强化峰值（peakenhancement，PE）：腺癌（29．61HU±10．34HU）〉鳞癌（21．84HU±7．57HU）〉小细胞肺癌（18．60Hu±12．19HU）（F=3．912，P=0．030〈0．05），两两比较（SNK）结果为小细胞肺癌与腺癌间有统计学差异，鳞癌与腺癌、小细胞肺癌间差异无统计学意义。3种病理类型的灌注值（perfusionvalue）、对比剂到达峰值时间（timetopeak，TTP）、血容量（bloodvolume，BV）差异无统计学意义。以细胞分化程度进行区组比较鳞癌和腺癌，结果为鳞癌和腺癌间PE值差异有统计学意义（F=5．516，P=0．026〈0．05）。结论CT灌注能反映肺癌组织类型间的差异，有助于对肺癌病理类型进行预判。Objective To analyze CT perfusion characters of lung cancer , so that to understand the blood--supply of different histological types of lung cancer in vivo and to improve the ability of predicting the pathological type. Methods 37 patiens suspected clinically with lung cancer underwent CT perfusion imaging . The image data were dealed with perfusion software to gain the time-- attenuation curve , perfusion parameters and artificial picture . The perfusion parameters among different histological types of lung cancer were analyzed comparatively with SPSS 11.5 . Results In 37 patients ,16 with squamous cell carcinomas（ SCC ） , 15 with adenocarcinomas （ AC ） and 6 with small cell lung cancers（ SCLC ） confirmed by pathology . The peak enhancement（PE） value of AC （29.61 HU±10.34 HU）was higher than that of SCC （21.84 HU±7.57 HU） and SCLC{18.60 HU±12.19 HU）, the PE value of SCC was higher than that of SCLC. The difference of PE value was statistically significant between AC and SCLC （F= 3. 912, P 0. 030%0.05）. No significant differences were revealed between PE value of SCC and AC or SCLC,respectively by SNK. PER, TTP and BV were no of significant differences among SC,AC and SCLC . Based on the tumor cell differentiated level, the difference of PE value was statistically significant between SCC and AC （F= 5. 516,P= 0. 026〈0.05）. Conclusion The defference of histological type of pulmonary carcinoma may be detected and the histological types of lung cancer can be distinguished at some level with CT perfusion imaging.

关 键 词：肺 灌注成像 体层摄影术 X线计算机 肺癌 病理学 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]