多层螺旋CT征象与灌注参数对周围型小肺腺癌淋巴结转移的评估价值  

Evaluation Value of Multi-spiral CT Signs and Perfusion Parameters for Lymph Node Metastasis in Peripheral Lung Adenocarcinoma

作　　者：夏宾[1] 朱景瑞[1] 谭华伟 葛涛[2] 白永杰[2] XIA Bin;ZHU Jingrui;TAN Huawei(Pingdingshan First People's Hospital,Pingdingshan,467045)

机构地区：[1]河南省平顶山市第一人民医院,467045 [2]郑州市第二人民医院,暨南大学附属郑州医院,450000

出　　处：《实用癌症杂志》2022年第9期1549-1553,共5页The Practical Journal of Cancer

摘　　要：目的探讨多层螺旋CT征象与灌注参数对于周围型小肺腺癌淋巴结转移的评估价值。方法选取经病理确诊为周围型小肺腺癌的患者90例,所有患者均先后行MSCT扫描,分析淋巴结转移与CT征象及灌注参数的关系,以病理结果为金标准,分析多螺旋CT扫描对周围型小肺腺癌淋巴结转移的评估价值。结果90例直径<3 cm的周围型小肺腺癌中共有21例发生淋巴结转移;不同淋巴结转移状况患者肿瘤位置、肿瘤增强CT值、病灶-肺界面、分叶征、淋巴结边界征象比较(P>0.05);有淋巴结转移患者毛刺征、胸膜凹陷征比例高于无淋巴结转移患者,肿瘤直径、纵膈或肺门淋巴结短径大于无淋巴结转移患者(P<0.05);不同淋巴结转移状况患者MSCT灌注参数血容量(BV)比较(P>0.05);有淋巴结转移患者血流量(BF)和强化峰值(PEI)低于无淋巴结转移患者(P<0.05);Logisitic回归分析显示:肿瘤直径大、毛刺征、胸膜凹陷征、纵膈或肺门淋巴结短径、低BF值、低PEI值是影响周围型小肺腺癌淋巴结转移的独立危险因素;肿瘤直径、毛刺征、胸膜凹陷征、纵膈或肺门淋巴结短径、BF值、PEI值联合评估周围型小肺腺癌淋巴结转移ROC曲线下面积为0.882,高于各项指标单独评估0.681、0.652、0.644、0.728、0.669、0.661(P<0.05)。结论周围型小肺腺癌淋巴结转移与肿瘤直径、纵隔/肺门淋巴结短径、毛刺征、胸膜凹陷征以及灌注参数PEI值、BF值有关,MSCT扫描在判断周围型小肺腺癌患者出现淋巴结转移的风险评估方面具有较高的应用价值。Objective To explore the evaluation value of multi-slice spiral CT(MSCT)signs and perfusion parameters for lymph node metastasis in peripheral lung adenocarcinoma.Methods 90 patients with small peripheral lung adenocarcinoma confirmed by pathology were selected.All patients underwent MSCT scan successively to analyze the relationship between lymph node metastasis and CT signs and perfusion parameters.With pathological results as the gold standard,the evaluation value of multi-spiral CT scan for lymph node metastasis of small peripheral lung adenocarcinoma was analyzed.Results Lymph node metastasis was found in 21 of 90 cases of peripheral small lung adenocarcinoma<3cm in diameter.Comparison of tumor location,tumor enhanced CT value,focus-lung interface,lobulation signs and lymph node boundary signs among patients with different lymph node metastasis status(P>0.05);The proportion of burr and pleural depression in patients with lymph node metastasis was higher than that in patients without lymph node metastasis,and the tumor diameter,mediastinum or hilar lymph node short diameter were higher than those in patients without lymph node metastasis(P<0.05).Comparison of blood volume(BV)of MSCT perfusion parameters in patients with different status of lymph node metastasis(P>0.05);Blood flow(BF)and enhancement peak(PEI)in patients with lymph node metastasis were lower than those in patients without lymph node metastasis(P<0.05).Logisitic regression analysis showed that large tumor diameter,burr sign,pleural depression sign,short mediastinal or hilar lymph node diameter,low BF value and low PEI value were independent risk factors for lymph node metastasis of peripheral small lung adenocarcinoma.The area under ROC curve of tumor diameter,burr sign,pleural depression sign,mediastinal or hilar lymph node short diameter,BF value and PEI value in combined evaluation of peripheral small lung adenocarcinoma lymph node metastasis was 0.882,which was 0.681,0.652,0.644,0.728,0.669,0.661(P<0.05).Conclusion Lymph node metastasis of p

关 键 词：周围型小肺腺癌 多螺旋CT 灌注参数 淋巴结转移 

分 类 号：R734.2[医药卫生—肿瘤]