MSCT灌注成像对肺内肿块的定性及定量研究

Pulmonary Nodules:Multislice CT Perfusion Imaging and Correlation with Microvessel Density and Vascular Endothelial Growth Factor

目的:探讨多层CT灌注成像对肺部肿块的诊断价值并与肿瘤血管生成进行相关性分析。方法:对53例确诊的肺部结节或肿块性病变进行CT灌注成像。分析并记录血流量(BF)、血容量(BV)、平均通过时间(MTT)和毛细血管表面通透性(PS)。27例手术切除标本进行免疫组化染色,测定MVD和VEGF表达值,并与CT灌注参数进行相关性分析。结果:3组结节间BF、BV、PS值均表现为恶性>炎性>良性;恶性结节的BF、BV和PS值均显著高于良性结节,差异有极显著性意义(P<0.01);恶性与炎性结节间、炎性与良性结节间PS值差异有显著性意义(P<0.05),BF和BV值差异无显著性意义(P>0.05)。3组结节间MTT值差异无显著性意义(P>0.05)。MVD及VEGF与BF、BV及PS值之间均具有正相关性,与MTT值无明显相关性。结论:CT灌注成像能较全面地反映肺部病变的血流信息,可为肺部病变的鉴别诊断及评价肺癌血管生成提供依据。

Objective:To Evaluate the efficacy of multi-slice CT perfusion imaging for differential diagnosis of pulmonary nodules (masses) and to correlate results with extent of tumor angiogenesis in pathologic specimens.Methods:Fifty three patients with pulmornary nodules or masses (<6cm) proved by pathology or clinic underwent CT perfusion imaging.The CT perfusion imaging parameters including blood flow (BF) blood volume(BV),mean transit time (MTT) and permeablity surface were calculated and correlated with extent of microvessel density (MVD) and vascular endothelial growth factor (VEGF) staining.Results:Malignant nodules showed significant higher value of BF,BV and PS than that of benign nodules (P>0.01);There was statistic significant difference in PS among the three groups (P<0.05),with no significant difference in BV and BF between inflammtory and benign nodules,or malignant and inflammtory nodules (P>0.05).No statistic significant difference in MTT was found among the three groups.BF,BV,PS showed statistic significant correlation with extent of MVD and VEGF staining,while MTT showed no significant correlation.Conclusion:MSCT perfusion imaging technique is helpful in the diagnosis of pulmonary nodules and coumd be a important imaging methods for evaluation tumor angiogenesis in patients with lung cancer.