双源CT双能量肺灌注成像的初步观察

Initial study of dual energy lung perfusion imaging using duni-source CT

目的评价双源CT双能量扫描肺灌注成像的临床应用价值。方法选择2007年5月至8月临床怀疑肺部疾病的连续54例患者行肺部增强双能量扫描，按照肺部不同病变分为4组：正常组、渗出性病变组、肿块性病变组和肺栓塞组。分析不同组别之间双能量CT灌注成像的表现。结果正常组14例，肺部双能量灌注成像表现双侧肺部灌注对称，未见明显差异。渗出性病变组10例，表现为局部灌注量降低；肿块性病变组27例，因为发生位置不同肺部灌注成像表现各异，外周性肿块表现为局部肿块区域的灌注缺损，而中央型肿块因为累及肺门血管而表现为肺段性灌注降低区或缺损区。肺栓塞组3例，表现为肺栓塞区域的灌注缺损或稀疏。结论利用双源CT双能量扫描可以观察肺的灌注状态，尤其有利于评价中央型肺癌和肺栓塞患者肺灌注的异常。

Objective To evaluate the clinical values of dual energy lung perfusion using dualsource CT. Methods Fifty-four patients who underwent chest contrast-enhanced CT were included in this study from May to August in 2007. Dual energy CT scanning was performed in all patients. The patients were divided into four groups： normal group, exudation lesion group, mass lesion group, and pulmonary embolism group. Imaging appearances of dual energy CT perfusion in four groups were analyzed. Results Dual energy CT showed symmetrical homogeneous perfusion in healthy subjects （n = 14）, exudation lesions （n = 10） appeared as low perfusion, In mass lesions （n =27）, peripheral masses presented as local perfusion defect, central masses appeared as segmental perfusion defect because of the involvement of hilar vessels, and pulmonary embolism （n = 3 ） appeared as perfusion defect in corresponding pulmonary segment. Conclusion Dual energy CT scanning can be used to show the pulmonary perfusion status and assess the pulmonary perfusion abnormalities in central lung cancer and pulmonary embolism.