颈部淋巴结CT灌注成像与微血管密度的研究  

Study on CT perfusion imaging and microvascular density of neck lymph nodes

作　　者：张玉婷[1] 姜永宏[1] 马荣泽 刘正华[1] 梁凯[1] ZHANG Yuting;JIANG Yonghong;MA Rongze;LIU Zhenghua;LIANG Kai(CT Room,Honghui Hospital,Xi'an Jiaotong University,Xi'an 710054,China;Department of Oncology Radiotherapy,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061)

机构地区：[1]西安交通大学附属红会医院CT室,陕西西安710054 [2]西安交通大学第一附属医院肿瘤放疗科,陕西西安710061

出　　处：《实用放射学杂志》2020年第4期546-549,共4页Journal of Practical Radiology

摘　　要：目的探讨CTP对于颈部良、恶性淋巴结的诊断价值,并研究各灌注参数与微血管密度(MVD)的相关性.方法回顾性分析经病理确诊的颈部淋巴结病变共52例,其中恶性40例;良性12例.所有患者术前均行CTP检查.分析比较良、恶性淋巴结病变各灌注参数包括血流量(BF)、强化峰值(PEI)、达峰时间(TTP)及血容量(BV)之间的差异,并通过灌注参数的ROC曲线分析,检测其诊断性能.将相应层面病理切片行免疫组化染色,检测其MVD并比较各灌注参数与之相关性.结果(1)颈部淋巴结恶性病变的BF及BV值均高于良性病变,其差异有统计学意义.(2)BF、PEI、TTP及BV的AUC均>0.9,各灌注参数对颈部淋巴结病变良、恶性鉴别的诊断效能较高.(3)颈部淋巴结病变CT灌注参数BF、PEI、BV与MVD呈正相关.结论CTP作为一种功能学成像方法有助于颈部良、恶性淋巴结病变的鉴别诊断.CT灌注参数与MVD密切相关,可以反映颈部淋巴结微循环及血管生成情况.Objective To investigate the diagnostic value of CT perfusion(CTP)in benign and malignant lymph nodes in neck,and to study the correlation between every perfusion parameter and microvascular density(MVD).Methods A total of 52 cases with neck lymphadenopathy diagnosed by pathology were analyzed retrospectively,including 40 cases of malignant and 12 cases of benign.All patients underwent CTP examination before surgery,and the parameters including blood flow(BP),peak enhancement intensity(PEI),time to peak(TTP),and blood volume(BV)were compared between benign and malignant lymph nodes.Meanwhile,the diagnostic performance was detected by ROC curve of perfusion parameters.Immunohistochemistry staining was performed on the pathological sections of the corresponding layer,then the MVD was measured and the correlation with each perfusion parameter was compared.Results(1)The BF and BV values of neck malignant lymph nodes were higher than those of benign,and the difference was statistically significant.(2)The AUC of BF,PEI,TTP and BV were all greater than 0.9,and each perfusion parameter had a high diagnostic efficiency in the differentiation of benign and malignant between neck lymph node lesions.(3)There was positive correlation between BF,PEI,BV and MVD in neck lymphadenopathy.Conclusion As a functional imaging method,CTP may be helpful for the differential diagnosis of benign and malignant lymphadenopathy in neck.CT perfusion parameters are closely related to MVD,which can reflect the microcir-culation and angiogenesis of neck lymph nodes.

关 键 词：颈部 淋巴结 计算机体层成像 灌注成像 

分 类 号：R733.4[医药卫生—肿瘤] R814.42[医药卫生—临床医学]