CT灌注强化指标和微血管密度与非小细胞肺癌淋巴结转移的相关性  

Correlation between CT perfusion reinforced indices,microvessel density and lymphatic involvement in non-small cell lung cancer

作　　者：顾艳[1] 周胜利[1] 袁刚[1] 王宗盛[1] 

机构地区：[1]连云港市第一人民医院影像科,江苏222000

出　　处：《放射学实践》2014年第10期1173-1176,共4页Radiologic Practice

摘　　要：目的:应用16层MSCT灌注成像定量评价肺癌肿瘤血管生成,并探讨CT灌注成像强化指标和肿瘤微血管密度(MVD)与肺癌淋巴结转移的关系及其价值。方法:对72例非小细胞肺癌行CT灌注扫描,根据首过期肿块强化的时间-密度曲线(TDC)计算肿瘤的灌注强化指标,根据病理结果分为有淋巴结转移组和无淋巴结转移组,并对肿瘤MVD计数。淋巴结转移组与无转移组各观察指标的差异采用t检验或t'检验;将CT灌注强化指标分别与MVD做相关性分析;利用ROC曲线分析MVD和CT灌注强化指标评价肺癌淋巴结转移的诊断效能。结果:肺癌淋巴结转移组(26例)MVD计数高于无淋巴结转移组(27例),MVD分别为(59.50±7.08)、(49.68±8.10)个/0.74mm2(t=-5.045,P<0.01)。淋巴结转移组肿块的BV高于无淋巴结转移组(BV分别为8.99±3.25、5.94±2.88),差异有统计学意义(t值为-4.159,P<0.05)。BV、BF、MTT均与MVD呈正相关,其中BV与MVD的相关系数最高(r=0.895,P<0.05)。利用ROC曲线分析,MVD、BV判断肺癌淋巴结转移有较高的诊断价值(曲线下面积分别为0.850和0.873,P>0.05);当以MVD≥54个/0.74mm2或BV≥7ml/100g作为强烈提示肺癌淋巴结转移的可能性时,其敏感度、特异度、诊断符合率、阳性预测值和阴性预测值均较高。结论:CT灌注中的BV值可作为术前判断肺癌淋巴结转移的重要指标之一。Objective：To explore the correlation between CT perfusion imaging reinforced indices,microvessel density （MVD）and lung cancer lymph nodes metastasis and its practical significance by applying 64 slice MSCT perfusion imaging for quantitative evaluation of lung tumor angiogenesis.Methods：72 cases of non-small cell lung cancer underwent CT perfu-sion scanning,tumor perfusion reinforced index was calculated according to the time-density curve （TDC）of first pass phase.According to the pathological results,72 cases were divided into the lymph node metastasis group and non-lymph-node-metastasis group,and MVD count was made.Indices differences between lymph node metastasis group and non-me-tastasis group were examined with t test or t＇test;then correlation analysis of CT perfusion reinforced index and MVD was conducted;ROC curve was used to analyze MVD and CT perfusion reinforcement index in bid to evaluate the diagnostic ef-ficacy of lung cancer lymph node metastasis.Results：MVD counts of the lung cancer group with lymph node metastasis （26 cases）were higher than the group without metastasis （27 cases）,which were （59.50±7.08）and （49.68±8.10）/0.74mm2 respectively （t=-5.045,P 〈0.01 ）.BV of the lymph node metastasis group was higher than that of the non-metastasis group [BV were （8.99±3.25）and （5.94±2.88）ml/100g respectively];the difference had great statistical significance （t=-4.159,P 〈0.05）.BV,BF,MTT were positively associated with MVD,and the correlation coefficient between BV and MVD was the highest （r=0.895,P 〈0.05）.Analyzing MVD and BV with the ROC curve was of great value in the diagno-sis of lung cancer lymph node metastasis （Az values were 0.850 and 0.873,P 〉0.05）;When MVD ≥ 54/0.74mm2 or BV≥7 served to suggest the possibility of lymphatic metastasis of lung cancer,the sensitivity,specificity,accuracy,positive predictive value and negative predictive values were relatively high.Conclusion：BV value of CT perfusion can be regarded as one of t

关 键 词：肺肿瘤 病理学 淋巴转移 灌注成像 体层摄影术 X 线计算机 

分 类 号：R730.44[医药卫生—肿瘤] R734.2[医药卫生—临床医学] R733.4