能谱CT肺灌注血容量图对肺癌癌周组织灌注的定量研究  

Lung perfused blood volume with spectral CT imaging as a new quantitative tool assess the contrast material distribution of the pulmonary parenchyma in patients with lung cancer

作　　者：李梦颖[1] 浦仁旺[1] 李智勇[1] 葛莹[1] 包如意[1] 刘爱连[1] 

机构地区：[1]大连医科大学附属第一医院放射科,辽宁大连116011

出　　处：《中华肿瘤防治杂志》2013年第18期1433-1435,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:采用能谱CT肺灌注血容量(lung perfused blood volume,LPBV)图像对肺癌组织癌周灌注进行定量分析研究。方法:对临床资料完整且均经病理确诊的30例肺癌患者行能谱CT平扫及增强扫描,增强扫描的延迟时间分别为25、55和140s。在平扫图像上测量肿瘤直径,在增强动脉期的LPBV图像上分别测量肺癌实质、癌周<3cm的肺组织及健侧对应区域内的肺组织的灌注碘基值。比较所有病例及周围型肺癌中癌周灌注与健侧肺灌注的差异性,比较不同肺癌分型(中心型与周围型)癌周灌注的差异性,并对癌周灌注与肿瘤大小、肿瘤实质灌注与肿瘤大小、肿瘤实质灌注与癌周灌注进行相关性分析。结果:癌周肺灌注与健侧肺灌注分别为(0.74±0.56)和(1.20±0.53)mg/mL,差异有统计学意义,t=-5.60,P<0.01;癌周灌注在中心型和周围型肺癌分型之间差异无统计学意义,t=-1.79,P=0.08;癌周灌注与肿瘤大小之间无相关性,r=-0.31,P=0.09;癌周灌注与肿瘤实质灌注存在相关性,r=0.42,P=0.02;肿瘤实质灌注与肿瘤大小之间存在一定的相关性,r=-0.57,P<0.01。结论:能谱CT的LPBV图像有助于更好地了解肺癌周围组织的灌注情况,对肺癌诊疗有一定的临床价值。OBJECTIVE：To quantitatively investigate the pulmonary blood flow and its change induced by lung cancer by measuring the iodine concentration distribution in pulmonary parenchyrna on lung perfused blood volume （LPBV） images with spectral CT imaging. METHODS： Thirty patients with lung cancer （ten cases central lung cancer, twenty cases peripheral lung cancer）, confirmed by pathology and underwent spectral CT imaging with a standard injection protocol, were enrolled in this stud- y. LPBV images were generated by analysis of the iodine content of the lung parenchyma. The average diameter of lung cancer was measured in plain CT scaru We evaluated the quantification of lung PBV using a workstation including lung tumor, pulmonary pa- renchyma in the distal end of lung cancers and the corresponding area in the contra-lateral normal lung on the LPBV images. RE- SULTS： Mean lung PBVs [（0.74±0. 56） mg/mL] for the pulmonary parenchyma in the distal end of lung cancers was signifi- cantly lower than that in the corresponding area in the contra-lateral normal lung [-（ 1.20 ±0.53） rag/mL, t =- 5.60, P〈0. 01 ]. In peripheral lung cancer, it was not significantly lower than that in central lung cancer （t=- 1.79 ,P= 0. 08）. The lower PBVs were not related to the sizes of tumor （r=- 0.31, P = 0.09）. However, there was a positive correlation between tumor PBVs and lung PBVs for the pulmonary parenchyma in the distal end of lung cancers （r= 0.42, P= 0.02） and a negative correlation be- tween tumor PBVs and the sizes （r= -0.57 ,P〈0. 01）. CONCLUSIONS： LPBV with spectral CT imaging can be used to quanti- tatively evaluate the pulmonary blood flow and its change induced by lung cancers. There is a correlation between tumor perfusion and pulmonary blood flow of the affected lung areas,

关 键 词：肺肿瘤 能谱CT 血流灌注 灌注 局部 

分 类 号：R734.2[医药卫生—肿瘤]