颈部淋巴结病变的CT灌注成像研究

Study of CT Perfusion Imaging in Cervical Lymph Nodes Lesions

【目的】探讨CT灌注成像在颈部淋巴结病变中的诊断价值。【方法】对58例颈部淋巴结病变患者进行CT灌注成像检查，其中恶性22例，良性36例，分析比较不同病理类型淋巴结病变的时间-密度曲线（TDC）和CT灌注参数差异。【结果】淋巴结恶性病变TDC多为A型（66．7％），淋巴结良性病变TDC多为C型（54．6％），B型曲线在良性和恶性淋巴结病变中均可见到；淋巴结恶性病变的灌注血流量（BF）值及血容量（BV）值均高于良性病变（P〈0．05），腺癌淋巴结转移灶BF值及BV值高于鳞癌淋巴结转移灶及淋巴瘤，鳞癌淋巴结转移灶的BF值高于淋巴瘤，淋巴瘤的平均通过时间（MTT）值长于鳞癌及腺癌淋巴结转移灶（P〈0．05）。【结论】不同病理类型的颈部淋巴结病变的灌注特点不同，CT灌注成像有助于颈部淋巴结病变的鉴别诊断。

[Objective]To investigate the diagnostic value of CT perfusion imaging in the cervical lymph nodes（CLN） lesions. [Methods]CT perfusion imaging were performed in 58 patients with 22 benign and 36 malignant CLN lesions. The data of time-density curve （TDC） and perfusion parameters were analyzed statistically among different types of CLN lesions. [Results]The characteristics of benign and malignant lesions of TDC showed that type A was the majority in malignant lymph lesions（66.7% ）, type C was the most in benign lymph lesions（54.6 % ）and type B was both in benign and malignant Lymph lesions. BF and BV of malignant lesions were higher than those of benign lesions（ P 〈0.05）. BF and BV of adenearcinoma carcinoma were higher than those of squamous carcinoma and lymphoma, and BF of squamous carcinoma was higher than that of lymphoma, and MTT of lymphoma was longer than that of adencareinoma and squamous carcinoma（ P 〈0. 05）. [Conclusion]The TDC and the parameters of CT perfusion imaging among the various lymph nodes lesions have different characteristics,so it is valuable in differential diagnosis of CLN lesions.