320排CT双入口灌注成像对孤立性肺结节的诊断价值  

Value of 320 Slice CT with Dual-input Perfusion Imaging in Diagnose of Patients with Solitary Pulmonary Nodule

作　　者：郭成伟[1] 全显跃[4] 陈为军[1] 梁文[4] 李红[2] 孙文超[1] 张乐[1] 李长云[3] GUO Cheng-wei;QUAN Xian-yue;CHEN Wei-jun;LIANG Wen;LI Hong;SUN Wen-chao;ZHANG Le;LI Chang-yun(Department of Radiology,252 Hospital of PLA,Baoding,Hebei 071000,China;Department of Pharmacy,252 Hospital of PLA,Baoding,Hebei 071000,China;Department of Ultrasonography,252 Hospital of PLA,Baoding,Hebei 071000,China;Department of Radiology,Zhujiang Hospital,South Medical University,Guangzhou 510282,China)

机构地区：[1]解放军第252医院放射科,河北保定071000 [2]解放军第252医院药剂科,河北保定071000 [3]解放军第252医院超声科,河北保定071000 [4]南方医科大学珠江医院放射科,广州510000

出　　处：《解放军医药杂志》2019年第8期82-85,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：广东省自然科学基金(S2013010016104)

摘　　要：目的探讨320排容积CT双入口灌注(DI-CTP)成像参数对孤立性肺结节(SPN)鉴别诊断价值。方法回顾性分析我院2015年8月—2018年3月经手术或穿刺病理证实的直径≤3cm影像学表现为孤立性结节46例,按病理结果分为腺癌组15例,鳞癌组12例,炎性结节组11例,活动性结核组8例。均经320排DI-CTP检查,记录肺动脉灌注量(PF)、支气管动脉灌注量(BF)和灌注指数(PI)。比较4组结节灌注参数间的统计学差异。结果腺癌组PF高于鳞癌组、活动性肺结核组、炎性结节组,且鳞癌组、活动性结核组、炎性结节组间均有显著差异(P<0.05);鳞癌组BF高于腺癌组、活动性肺结核组、炎性结节组,且腺癌、活动性肺结核、炎性结节组间均有显著性差异(P<0.05);腺癌PI低于鳞癌组、炎性结节组和活动性肺结核组(P<0.05);但炎性结节组与鳞癌组、活动性肺结核组之间比较差异均无统计学意义(P>0.05)。结论320排DI-CTP从肺动脉(PF)、支气管动脉(BF)及灌注指数(PI)等多方面对肺结节的血流动力学进行评价,对提高SPN鉴别诊断价值具有较大临床意义。Objective To investigate value of 320 slice CT with dual-input perfusion imaging(DI-CTP)parameters in differential diagnosis of patients with solitary pulmonary nodules(SPN).Methods Clinical data of 46 SPN patients with nodule diameter equal or less than 3 cm,who were confirmed by operation or puncture pathology during August 2015 and March 2018 was retrospectively analyzed,and the patients were divided into adenocarcinoma group(n=15),squamous cell carcinoma group(n=12),inflammatory nodule group(n=11)and active tuberculosis group(n=8)according to pathological Results.All patients received examinations of 320 slice CT with DI-CTP.Pulmonary artery perfusion(PF)volume,bronchial artery perfusion(BF)volume and perfusion index(PI)were recorded.Statistical differences of nodule perfusion parameters were compared among four groups.Results PF value in adenocarcinoma group was significantly higher than those in squamous cell carcinoma,active tuberculosis and inflammatory nodule groups and the differences in PF values were statistically significant in squamous cell carcinoma,active tuberculosis and inflammatory nodule groups,and the differences in PF values were statistically significant in squamous cell carcinoma,active tuberculosis and inflammatory nodule groups(P<0.05).BF value in squamous cell carcinoma group was significantly higher than those in adenocarcinoma,active pulmonary tuberculosis and inflammatory nodule groups,and there were significant differences in the values in squamous cell carcinoma,active tuberculosis and inflammatory nodule groups(P<0.05).PI value in adenocarcinoma group was significantly lower than those in squamous cell carcinoma,inflammatory nodule and active tuberculosis groups(P<0.05),but the value in inflammatory nodule group showed no significant differences with those in squamous cell carcinoma and active pulmonary tuberculosis groups(P>0.05).Conclusion The 320 slice CT with dual-input perfusion imaging may be used to evaluate hemodynamics of SPN through many aspects such as PF,BF and PI,and

关 键 词：孤立性肺结节 灌注成像 血流动力学 X线断层摄影 

分 类 号：R521.6[医药卫生—内科学]