320排CT双入口灌注参数诊断肺内占位性病变的初步探讨  

Preliminary study of 320-slice dynamic volume CT dual-input perfusion parameter for diagnosis of pulmonary space occupying lesions

作　　者：彭楠 陈殿森[2] 徐志宾[2] PENG Nan;CHEN Diansen;XUN Zhibin(College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China)

机构地区：[1]河南科技大学临床医学院河南洛阳471003 [2]河南科技大学第一附属医院影像科河南洛阳471003

出　　处：《实用医学杂志》2018年第7期1157-1161,共5页The Journal of Practical Medicine

摘　　要：目的初步探讨320排容积CT双入口灌注参数对肺内占位性病变诊断的价值。方法前瞻性地分析2016年5月至2017年5月在河南科技大学第一附属医院行CT灌注检查的肺部占位性病变106例,所有病例最终经病理学明确诊断,其中恶性病变85例,包括肺鳞癌38例,肺腺癌34例,肺小细胞癌11例,肺肉瘤并腺癌2例;良性病变21例,其中炎性包块19例,硬化性血管瘤2例。通过320排CT动态容积扫描后,利用灌注软件计算得到肺内病变的灌注参数:肺动脉血流量(PF)、支气管动脉血流量(BF)和灌注指数(PI),其中PI=PF/PF+BF。结果肺内恶性肿块BF值大于良性,PI值小于良性,良恶性肿块的BF、PI值差异具有统计学意义(P<0.01),其中PI的ROC曲线下面积最大,为0.933。取PI≤52.75阈值,确诊恶性病变的敏感度为81.0%,特异度为91.9%。肺腺癌跟肺小细胞癌PF值差异有统计学意义(P<0.01),肺鳞癌跟肺腺癌,肺腺癌跟肺小细胞癌PI值差异有统计学意义(P<0.05)。结论 320排CT双入口灌注指数PI可以作为肺部良恶性病变影像诊断的重要参考数据,PF值及PI值能够对本次研究中3种肺癌的诊断和治疗提供一定的指导。Objective To investigate the value of 320-slice dynamic volume perfusion parameter in the diagnose Of pulmonary occupying lesions. Methods A prospective analysis of 106 cases of pulmonary space occupying lesions by CT perfusion at the First Affiliated Hospital of Henan University of Science and Technology from May 2016 to May 2017. All eases were diagnosed by pathology. Among the objects, 85 eases were with malignant lesions, including squamous cell carcinoma （n = 38） adenocarcinoma （n = 34） , small cell carcinoma （n = 11 ） and carcinosarcoma associated ad （n = 2）. A total of 21cases were benign lesions, includ- ing inflammatory mass （n = 19） and sclerosing angioma （n = 2）. All the cases underwent 320-slice CT dual-input volume perfusion scanning and the blood flow perfusion parameters of lesions ： pulmonary flow （PF）, bronchial flow （ BF ） and perfusion index （ PI = PF/PF ＋ BF ） were acquired by perfusion software. Results BF of malignant lesions was higher than that of benign lesions and the PI was lower than that of benign ones. Statistically significant differences of BF and PI were found between malignant and benign lesions （P 〈 0.01 ）. The area under the ROC curve of PI was 0.933, the largest of the three perfusion parameters. If PI is less than or equal to 52.75 as the threshold of malignant lesions, the diagnostic sensitivity was 81%, specificity was 91.9%.The difference of PF between adenocarcinoma and small cell carcinoma is statistically significant （P 〈 0.05）. Squamous carcinoma and adenocareinoma, adenocarcinoma and small cell carcinoma PI differences were found tb have statistical significance （P 〈 0.05 ）. Conclusions The value of 320-slice dynamic volume CT dual-input perfusion parameter PI can provide additional information for differential diagnosis of malignant from benign lung lesions. PF and PI value can provide some guidance for the diagnosis of three kinds of lung cancer in this study.

关 键 词：双入口灌注 肺部病变 鉴别 灌注指数 

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