灶周CT灌注参数对孤立性肺部球形病变的诊断价值  

Value of CT Perfusion in Diagnosing Solitary Pulmonary Spherical Lesions

作　　者：张庆华[1] 胡春洪[2] 顾光官[1] 

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

出　　处：《临床放射学杂志》2011年第6期813-816,共4页Journal of Clinical Radiology

摘　　要：目的探讨肺部孤立性球形病变灶周CT灌注(CT perfusion,CTP)参数定量分析的诊断价值。资料与方法选取位于肺动脉或右心室所在层面的孤立性肺部球形病变22例,其中恶性组14例(腺癌8例,肺泡癌3例,大细胞癌1例,腺鳞癌及血管外皮瘤各1例),良性组8例(炎性假瘤2例,活动性结核1例,结核球2例,硬化性血管瘤3例)。采用64层CT行灌注检查。将所得原始数据传至Syngo工作站行后处理得到CTP图,测量病变灶周及对侧肺与病变相对应区域的近、远肺门侧的血流量(BF)、血容量(BV)、表面通透性(PS)、平均通过时间(MTT)等灌注参数值。所有病例取得术后病灶近、远肺门侧边缘外1.0 cm范围内的肺组织以及远离病变区域的肺组织各一块,行免疫组织化学染色,比较微血管密度(MVD)有无差异。结果 (1)良、恶性组灶周近/远肺门侧灌注参数BF、BV、PS、MTT相对值(病变灶周灌注参数/对侧肺灌注参数)分别为rBF 1.37±0.59/0.99±0.38、0.88±0.53/0.92±0.41,rBV1.78±1.29/1.08±0.35、1.18±0.88/0.96±0.40,rPS 1.25±1.07/0.78±0.69、1.47±1.12/1.29±1.07,rMTT1.35±0.60/1.16±0.40、1.56±1.30/1.06±0.19;两组间各灌注参数相对值差异无显著统计学意义(P>0.05)。(2)良、恶性组灶周MVD相对值(病变灶周MVD值/同侧正常肺MVD值)分别为1.09±0.21和0.91±0.28,两者间差异无显著统计学意义(P>0.05)。结论良、恶性肺部球形病变灶周CTP参数值间有一定差异,但无统计学意义,对鉴别诊断无明确帮助。Objective To study the value of CT perfusion parameters in diagnosing solitary pulmonary spherical lesions.Materials and Methods Twenty two cases of solitary pulmonary spherical lesions,located at the cross-sectional level of pulmonary artery or right ventricle were divided into two groups-14 cases of malignant and 8 cases of benign masses.The patients underwent CTP with 64-slice CT.The raw data were post processed via Syngo workstation to produce CTP maps and parameters.The 3 specimens,achieved at the near-hilar-side margin,opposite-hilar-side margin of lesion and normal lung parenchyma were immunohistostained and MVD were counted.Results（1）The CTP parameters measured at near-hilar-side margin and opposite-hilar-side margin of lesion had no significant difference between benign and malignant groups（P0.05）.（2）The MVD ratio（MVD of peri-lesion/MVD of the normal lung）had no significant difference between benign and malignant groups（P0.05）.Conclusion CTP parameters achieved at the lesion margin have no definite value in the differential diagnosis of pulmonary spherical lesions.

关 键 词：体层摄影术 X线计算机 灌注成像 肺肿瘤 微血管密度 

分 类 号：R563[医药卫生—呼吸系统] R816.41[医药卫生—内科学]