恶性孤立性肺结节血流模式与结节大小的关系探讨

Correlation between the quantifiable parameters of blood flow pattern derived with dynamic CT in maliag-nant solitary pulmonary nodules and tumor size

背景与目的孤立肺结节是肺部的常见病变,多层螺旋CT的应用,为更好地定量评价孤立肺结节血流模式提供了可能。本研究的目的是探讨恶性孤立性肺结节血流模式与结节大小的关系。方法68例恶性孤立性肺结节(直径≤4 cm),行多层螺旋CT动态增强扫描(以4ml/s的速度注入对比剂,4×5mm或4×2.5 mm扫描模式,不动床)。记录孤立肺结节增强前后各时相的CT值并计算强化值、灌注值、结节-主动脉强化值比及平均通过时间,用线性回归分析评价恶性孤立性肺结节血流模式定量CT参数与结节大小的关系。结果恶性结节强化值、恶性结节的结节-主动脉强化值比、灌注值及平均通过时间与结节大小无关(r=0.18,P=0.14;r=0.20,P=0.09;r=0.01,P=0.95;r=0.01,P=0.93)。结论恶性孤立性肺结节血流模式定量CT参数不受结节大小的影响。

Background and Objective The solitary pulmonary nodules （SPNs） is one of the most common findings on chest radiographs. It becomes possible to provide more accurately quantitative information about blood flow patterns of solitary pulmonary nodules （SPNs） with multi-slice spiral computed tomography （MSCT）. The aim of this study is to evaluate the correlation between the quantifiable parameters of blood flow pattern derived with dynamic CT in maliagnant solitary pulmonary nodules and tumor size. Methods 68 patients with maliagnant solitary pulmonary nodules （SPNs） （diameter ≤4 cm）underwent multi-location dynamic contrast material-enhanced （nonionic contrast material was administrated via the antecubital vein at a rate of 4mL/s by an autoinjector, 4×5mm or 4×2.5mm scanning mode with stable table were performed.） serial CT. Precontrast and postcontrast attenuation on every scan was recorded. Perfusion （PSPN）, peak height （PHSPN）,ratio of peak height of the SPN to that of the aorta （SPN-to-A ratio）and mean transit time（MTT） were calculated. The correlation between the quantifiable parameters of blood flow pattern derived with dynamic CT in maliagnant solitary pulmonary nodules and tumor size were assessed by means of linear regression analysis. Results No significant correlations were found between the tumor size and each of the peak height （PHSPN） ,ratio of peak height of the SPN to that of the aorta （SPN-to-A ratio） ,perfusion （PSPN）and mean transit time（r=0.18,P=-0.14; r=0.20,P=0.09; r=0.01, P=0.95; r=0.01, P=0.93）. Conclusion No significant correlation is found between the tumor size and each of the quantifiable parameters of blood flow pattern derived with dynamic CT in maliagnant solitary pulmonary nodules.