增强CT扫描联合灌注成像对非小细胞肺癌临床分期及淋巴结转移的评估价值  

Evaluation value of enhanced CT scanning combined with perfusion imaging in preoperative staging and lymph node metastasis of non-small cell lung cancer

作　　者：庞宇菲 梁宁 常银江[1] PANG Yufei;LIANG Ning;CHANG Yinjiang(Radiology Department,The People's Hospital of Puyang City,Henan 457000,China)

机构地区：[1]河南省濮阳市人民医院放射科,457000

出　　处：《淮海医药》2025年第1期13-17,22,共6页Journal of Huaihai Medicine

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20210933)。

摘　　要：目的:探讨增强电子计算机断层(CT)扫描联合灌注成像对非小细胞肺癌(NSCLC)术前临床分期及淋巴结转移的评估价值。方法:回顾性选取某院2021年1月—2024年1月接受肺癌根治性手术治疗的125例NSCLC患者为研究对象,所有患者术前均接受增强CT扫描、灌注成像检查,以术后病理结果为金标准,比较不同临床分期、淋巴结转移状态患者增强CT扫描及灌注成像参数,ROC分析增强CT扫描联合灌注成像对NSCLC术前临床分期、淋巴结转移的评估价值。结果:术后病理诊断结果显示,125例NSCLC患者中Ⅰ期74例(59.20%),Ⅱ期51例(40.80%);出现淋巴结转移27例(21.60%),未出现淋巴结转移98例(78.40%)。Ⅱ期患者平扫期CT值及灌注成像血流量、血容量、表面通透性高于Ⅰ期,动脉期CT强化值、灌注成像平均通过时间低于Ⅰ期,差异有统计学意义(P<0.05);不同临床分期患者静脉期CT强化值比较,差异无统计学意义(P>0.05)。淋巴结转移患者的平扫期CT值及灌注成像血流量、血容量、表面通透性高于未转移患者,动脉期CT强化值、灌注成像平均通过时间低于未转移患者,差异有统计学意义(P<0.05);不同淋巴结转移状态患者静脉期CT强化值比较,差异无统计学意义(P>0.05)。ROC分析显示,增强CT扫描联合灌注成像评估NSCLC患者术前临床分期的AUC为0.964(95%CI:0.937~0.991,P<0.001),特异度为0.843,灵敏度为0.946;评估NSCLC患者术前淋巴结转移状态的AUC为0.954(95%CI:0.912~0.995,P<0.001),特异度为0.926,灵敏度为0.878。结论:增强CT扫描联合灌注成像对NSCLC患者术前临床分期及淋巴结转移状态具有较高的评估价值。Objective:To explore the evaluation value of enhanced electronic computed tomography(CT)scanning combined with perfusion imaging in preoperative staging and lymph node metastasis of non-small cell lung cancer(NSCLC).Methods:Clinical data from 125 NSCLC patients receiving surgical treatment in a hospital from January 2021 to January 2024 were retrospectively collected.All the patients underwent enhanced CT scan and perfusion imaging before operation.Using the postoperative pathological results as the gold standard,the application value of enhanced CT scan combined with perfusion imaging in the preoperative staging and lymph node metastasis evaluation of NSCLC was analyzed.Results:The results of postoperative pathological examination showed that among the 125 NSCLC patients,74 were in stage I(59.20%)and 51 were in stage II(40.80%).27 cases(21.60%)manifested lymph node metastasis,while 98 cases(78.40%)did not.The CT value,blood flow,blood volume and surface permeability of perfusion imaging in the stage II patients were higher than those in the stage I patients.The CT enhancement value and mean transit time of perfusion imaging in arterial phase were lower than those in the stage I patients,with statistical significant differences(P<0.05).The comparison of venous phase CT enhancement values between the two groups showed no statistical significant difference(P>0.05).The CT value and perfusion imaging blood flow,blood volume and surface permeability of the patients with lymph node metastasis were higher than those of patients without metastasis,and the CT enhancement value and mean transit time of perfusion imaging in arterial phase were lower than those of patients without metastasis,with statistical significant differences(P<0.05).The comparison of venous phase CT enhancement values between the two groups showed no statistical significant difference(P>0.05).The results of the receiver operating characteristic curve(ROC)showed that the area under the curve(AUC)of CT enhancement scan parameters combined with perfusion

关 键 词：癌 非小细胞肺 增强电子计算机断层扫描 灌注成像 淋巴结转移 评估价值 

分 类 号：R730.26[医药卫生—肿瘤] R814.42[医药卫生—临床医学]