甲状腺结节MSCT灌注成像与微血管密度相关性  

Correlation Between CT Perfusion and Microvessel Density in Patients with Thyroid nodules

作　　者：邹文远[1] 李胜[1] 刘源源[1] 田林[2] 刘玥[1] 石思李[1] 侯明伟[1] 

机构地区：[1]湖北医药学院附属人民医院放射科,十堰442000 [2]湖北医药学院附属人民医院病理科,十堰442000

出　　处：《临床放射学杂志》2013年第1期37-41,共5页Journal of Clinical Radiology

基　　金：湖北省教育厅科学技术研究项目(D20112103)

摘　　要：目的研究不同性质甲状腺结节CT灌注成像与微血管密度(MVD)的相关性。方法随机选取52例甲状腺病变患者,良性组40例,恶性组12例,均采用常规CT平扫和同层动态灌注扫描,计算出血流量(BF)、血容量(BV)、表面通透性(PS)、平均通过时间(MTT)及达峰时间(TTP),良恶性甲状腺结节CT灌注参数各值分别与各组病例术后病理免疫组织化学染色的MVD高倍镜下(×400)计数值进行Pearson相关分析,良性组及恶性组甲状腺结节CT灌注参数及MVD采用t检验。结果良、恶性甲状腺结节CT灌注参数BV值分别为(13.97±11.34)ml/100 g、(22.89±11.56)ml/100 g,良、恶性甲状腺结节BV差异有统计学意义(t=2.211,P=0.034<0.05),BF、TTP、PS、MTT差异均无统计学意义(P=0.234、0.112、0.614、0.709);良、恶性甲状腺结节的MVD间存在显著差异(t=7.621,P=0.000<0.001);良性组PS值与MVD间呈正相关(r=0.404,P=0.05),恶性组PS值与MVD间呈负相关(r=-0.601,P=0.039<0.05),其余各指标BF、BV、TTP、MTT与MVD间均无相关性。结论 CT灌注成像可对甲状腺结节微血管血流动力学状况进行量化评估,其各种灌注参数中以BV值对甲状腺良恶性病变的鉴别诊断价值最大,良、恶性甲状腺结节CT灌注参数PS与MVD具有良好的相关性,对术前间接评价肿瘤的血管生成及良恶性有重要价值。Objective To study the incidence relation between the microvessel density（MVD） and their CT perfusion in different types of thyroid nodules.Methods 52 cases with thyroid nodule were selected randomly and divided into two groups,benign group（40 cases） and malignant group（12 cases）.All cases received the conventional CT scan and layer dynamic perfusion scan,the data of blood flow（BF）,blood volume（BV）,permeability surface area product（PS）,mean transit time（MTT） and the time to peak（TTP） were calculated.Utilized Pearson＇s Analytic Model was used to analyze and compare the date of two groups＇ CT perfusion imaging with the postoperative microvessel density,pathological immunohistochemical method was taken under the high power microscope（×400） respectively.Results In two groups,the BV of CT perfusion parameters were（13.97 ± 11.34） ml/100 g,（22.89 ± 11.56） ml/100 g respectively,which had statistically significant difference（t=2.211,P=0.0340.05）,however the differences of BF,TTP,PS and MTT were not significance（P=0.234、0.112、0.614、0.709）;There were significant differences on the MVD between benign and malignant groups（t=7.621,P=0.0000.001）,the PS of benign group was proportion to MVD（r=0.404,P=0.05）.On the contrary,PS of the malignant group was inversely proportional to MVD（r=-0.601,P=0.0390.05）there was no direct correlation between BF,BV,the TTP,MTT and MVD.Conclusion CT perfusion imaging could be used on the quantitative evaluation of microvascular hemodynamics of thyroid nodules.The index of BV has great value in the differential diagnosis of the thyroid nodules.However,the PS and MVD of CT perfusion parameters have some direct correlations between benign and malignant thyroid nodules,which provide useful information for the evaluation of tumor angiogenesis.

关 键 词：甲状腺结节 灌注 微血管密度 体层摄影术 X线计算机 

分 类 号：R581[医药卫生—内分泌]