胰周淋巴结转移瘤的多层CT灌注成像研究

Multiple spiral CT perfusion imaging in differential diagnosis of peri-pancreatic metastatic lymph nodes

目的 使用多层螺旋CT的体部灌注软件，测量和评价胰周淋巴结转移瘤与良性增生肿大淋巴结CT灌注值的差异和相关性。方法采用Siemens SOMATOM Sensation Cardiac 64排螺旋CT体部灌注技术（0．4s／周），5mm层厚，4层，120kV，60mA；采用高压注射器注射非离子型对比剂40ml（300mgI／ml），流速4ml／s，延迟5S，数据采集40S。在工作站用Siemens Body Perfusion软件进行数据处理（去卷积算法），测量29例胰周淋巴结转移瘤和15例良性增生肿大淋巴结的血流量（BF），并进行统计学分析。结果胰周淋巴结转移瘤BF平均值为（53．63±10．82）ml·min^-1·100ml^-1，良性增生肿大淋巴结BF值为（29．78±7．52）ml·min^-1·100ml^-1，差别有显著统计学意义（P〈0．001）。结论MSCT灌注成像法对胰周淋巴结转移瘤的鉴别诊断具有临床应用价值。

Objective To measure and assess CT perfusion value for peri-pancreatic metastatic lymph node by using multiple spiral CT （MSCT） with body perfusion software package. Methods The MSCT perfusion imaging was performed for peri-pancreatic metastatic lymph nodes and muscle on a multi-section CT scanner （SOMATOM Sensation Cardiac 64-）. 4 × 5 mm collimation, 120 kV, 60mA. Contrast injection was done with 40 ml nonionic contrast agent （300 mg I/ml）, at a flow rate of 4.0 ml/s, and 5 seconds delay, and data acquisition lasted for 40 seconds. The mean blood flow （BF） were measured and analyzed in patients with pathologically proven peri-pancreatic metastatic lymph nodes （n = 29） and hyperplastic lymph nodes （n = 15 ） on work station using body perfusion software （ Siemens ） with deconvolution method. Results The mean BF in peri-pancreatic metastatic lymph nodes were （53.63 ± 18.82） ml·min^-1·100ml^-1, in hyperplastic lymph nodes were 29.78 ± 7.52ml·min^-1·100ml^-1, the difference was significant （P 〈 0. 001 ）. Conclusions Perfusion imaging of MSCT was useful in differentiation between peri-pancreatic metastatic lymph nodes and hyperplastic lymph nodes.