320排螺旋CT双入口灌注技术在肺结核的临床应用  

Dual-input lung perfusion with 320-MDCT:application of a new technique in pulmonary tuberculosis

作　　者：李利佳[1,2] 敖国昆 袁小东 李明星 许国宇 乔远罡[2] 秦崇[2] 韩东梅[2] 

机构地区：[1]解放军医学院,北京100853 [2]中国人民解放军第309医院(解放军总参谋部总医院)放射科,北京100091

出　　处：《放射学实践》2014年第3期283-287,共5页Radiologic Practice

基　　金：北京市科学技术委员会资助(Z131107002213076)

摘　　要：目的:探讨320排螺旋CT双入口灌注技术在定量评估活动性肺结核血流灌注中的临床应用价值,比较不同类型肺结核病灶的血流灌注情况。方法:23例肺结核病例按形态学分3组:结核球8例,空洞型病灶4例,浸润型病灶11例。所有患者均行全肺CT动态容积扫描,利用灌注软件获取兴趣区的灌注参数值:肺动脉血流量(PF)、支气管动脉血流量(BF)及灌注指数(PI),并对不同类型肺结核病灶的血流灌注参数进行统计学分析。结果:结核球病灶PF(41.51±10.32)ml/(min·100ml)、BF(11.87±5.76)ml/(min·100ml)、PI(0.72±0.09);浸润型病灶PF(82.53±51.57)ml/(min·100ml)、BF(40.20±19.06)ml/(min·100ml)、PI 0.66±0.07;空洞型病灶PF(36.15±12.88)ml/(min·100ml)、BF(23.69±4.51)ml/(min·100ml)、PI 0.51±0.14。3组病灶的PF值均大于BF值(P<0.05)。浸润病灶与结核球、浸润病灶与空洞型病灶的BF和PF值差异均有统计学意义(P<0.05),但结核球与空洞型病灶的BF、PF值差异无统计学意义。3组病灶的PI值差异无统计学意义。结论:对肺结核的血供灌注研究表明,结核性病变同时接受肺循环和体循环供血,其中肺循环占优势。3组病灶中浸润型病灶的灌注值(PF和BF)最高,空洞型病灶的PF值最低,结核球病灶的BF值最低。Objective：To explore the value of dual-input lung perfusion with 320-MDCT for quantifying blood supply in pulmonary tuberculosis and compare the perfusion characteristics of different types of tuberculosis. Methods： 23 cases of pulmonary tuberculosis were divided into 3 groups according to morphology： 8 cases of tuberculoma,4 cases of cavitary le- sions and 11 cases of infiltrative lesions. All the patients underwent lung dynamic volume CT scan. All the perfusion param eters of different types of tuberculosis lesions including pulmonary flow （PF）, bronchial flow （BF） and perfusion index （PI） of region of interest were acquired by the perfusion software and analyzed statistically. Results=PF,BF and PI of tuberculo ma were （41.51± 10.32 ） ml/（min· 100ml）, （ 11.87 ± 5.76 ） ml/（min· 100ml） and 0.72 ± 0.09 respectively. PF, BF and PI of infiltrative lesions were （82.53±51.57）ml/（min· 100ml）, （40.20±19.06）ml/（min· 100ml） and 0.66±0.08 respectively. PF,BF and PI of cavitary lesions were （36.15＋12.88）ml/（min. 100mi）,（23.69±4.51）ml/（min-100ml） and 0. 51±0.14 respectively. PFs were all greater than BFs in three types of tuberculosis （P〈0. 05）. BF and PF of infiltrative lesions were greater than tubereuloma and cavitary tuberculosis （P〈0.05）. There were no statistical differences in BF and PF between tuberculoma and cavitary tuberculosis. There were no statistical differences in PI between the three types of tuberculosis. Conclusions：The preliminary studies suggest that tuberculosis lesions were fed by both pulmonary circulation and systemic circulation,among which the former is dominant. The PF and BF value of infiltrative lesion are the maximum, the PF value of cavitary lesions is the minimum,the BF value of tuberculoma is the minimum.

关 键 词：体层摄影术 X线计算机 灌注 结核 肺 肺循环 

分 类 号：R816.41[医药卫生—放射医学]