320排CT低剂量容积体部灌注成像强化峰值时间对孤立性周围肺病变诊断价值  

The value of enhancement time to peak in the diagnosis of solitary peripheral pulmonary lesions using 320-slice CT dual-input low-dose perfusion imaging

作　　者：颜林军 郭成伟 孙文超 陈为军 刘茗露 张乐 杨卓 崔现成 李晓燕[3] 李长云 YAN Lin-jun;GUO Cheng-wei;SUN Wen-chao;CHEN Wei-jun;LIU Ming-lu;ZHANG Le;YANG Zhuo;CUI Xian-cheng;LI Xiao-yan;LI Chang-yun(Jingxi Medical District of PLA General Hospital,Beijing 100039,China;PLA 82 Group Hospital,Baoding Hebei 071000,China;No.1 Medical Center of PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院京西医疗区,北京100039 [2]陆军第八十二集团军医院,河北保定071000 [3]解放军总医院第一医学中心,北京100039 [4]陆军第八十二集团军医院医学影像科,河北保定071000

出　　处：《中国临床医学影像杂志》2022年第6期391-395,共5页Journal of China Clinic Medical Imaging

基　　金：国家卫健委医药卫生科技发展研究中心项目(GWJJ2021100304);河北省医学科研计划项目(20221908)。

摘　　要：目的:探讨320排CT低剂量容积体部灌注成像(DI-CTP)强化峰值时间(TTP)诊断孤立性周围肺病变的价值。方法:收集经手术或穿刺病理证实的孤立性周围肺病变67例:恶性周围肺病变44例、良性周围肺病变23例。应用DI-CTP绘制拟合时间密度曲线(T-DC)、测量TTP,分析体循环灌注量(BF)及肺循环灌注量(PF)及肺动脉灌注指数(PI),分析孤立性周围肺病变的DI-CTP参数间差异及其对周围病变的鉴别诊断价值。结果:良、恶性孤立性周围肺病变TTP、BF、PI均存在显著性差异(P<0.05),而PF对孤立性周围肺病变良恶性鉴别诊断无统计学意义(P>0.05);TTP、PI、BF对孤立性周围肺病变均具有较高的诊断价值((AUC_(TTP)=0.97)>(AUC_(PI)=0.73)>(AUC_(BF)=0.71),均P<0.01)。结论:DI-CTP定量参数有助于提高孤立性周围肺病变的诊断价值,TTP显著提高了孤立性周围肺病变的鉴别诊断效能。Objective: To evaluate the value of the time to peak(TTP) in the diagnosis of solitary peripheral pulmonary lesions by dual-input CT perfusion imaging(DI-CTP) on 320-slice CT. Methods: Sixty-seven cases of solitary peripheral pulmonary lesions proved by surgery or puncture pathology were collected, including 44 cases of malignant peripheral pulmonary lesions and 23 cases of benign peripheral pulmonary lesions. DI-CTP was used to draw the fitting time-density curve(T-DC)and the TTP were obtained by T-DC, and the bronchial artery perfusion(BF), pulmonary artery perfusion(PF) and pulmonary artery perfusion index(PI) were analyzed, and the differences between DI-CTP parameters of solitary peripheral pulmonary lesions and their value in differential diagnosis of peripheral lesions were analyzed. Results: There were significant differences in TTP, BF and PI between benign and malignant solitary pulmonary lesions(P<0.05), but PF had no statistical significance in the differential diagnosis of benign and malignant peripheral pulmonary lesions(P>0.05). TTP, PI and BF had high diagnostic value for solitary peripheral pulmonary lesions((AUC_(TTP)=0.97)>(AUC_(PI)=0.73)>(AUC_(BF)=0.71), all P<0.01). Conclusion: The quantitative parameter of DI-CTP can improve the differential diagnosis efficiency of solitary peripheral pulmonary lesions, and TTP significantly improves the differential diagnostic efficiency of solitary peripheral pulmonary lesions.

关 键 词：肺疾病 体层摄影术 X线计算机 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学]