肺孤立性病灶16层螺旋CT首过期灌注成像与血管生成的相关研究

The Correlation of 16-Slice Spiral CT Perfusion Imaging with Angiogenesis in Solitary Pulmonary Lesion

目的应用16层螺旋CT灌注成像(CTPI)技术,探讨肺孤立性病灶各灌注参数与病灶的微血管密度(MVD)、血管内皮细胞生长因子(VEGF)的相关性。资料与方法对52例肺孤立性病灶行16层螺旋CT首过期灌注成像,利用Body-perfusion软件进行后处理,获得感兴趣区的血流量(BF)、相对血容量(rBV)、毛细血管渗透性(Pm)、达峰时间(TTP)等灌注参数。其中39例手术患者的组织标本采用免疫组织化学染色后行MVD计数和检测VEGF表达。结果恶性组和炎性组的BF、rBV、Pm等参数均高于良性组,差异有统计学意义(P均<0.05);恶性组和炎性组仅Pm差异有统计学意义(P<0.05)。良性组的TTP略高于恶性组和炎性组,但各组间差异无统计学意义(P>0.05)。恶性组和炎性组的MVD、VEGF表达强度均高于良性组,差异有统计学意义(P均<0.05);但恶性组和炎性组之间MVD、VEGF表达强度的差异无统计学意义(P>0.05)。除TTP外,恶性组、炎性组和良性组的BF、rBV、Pm参数值与MVD、VEGF呈正相关(P均<0.05),其中以BF与MVD、VEGF和Pm与MVD、VEGF的相关性最高。结论肺孤立性病灶的CTPI参数与其血管生成有良好相关性,能定量地反映其血管生成情况,有助于对良恶性病灶的鉴别诊断。

Objective To evaluate the correlation of CT perfusion imaging （CTPI） parameters with microvessel density （MVD） and vascular endothelial growth factor （VEGF） in solitary pulmonary lesion using 16-slice spiral CT. Materials and Methods 52 patients with solitary pulmonary lesion received 16-slice spiral CT perfusion scanning. Perfusion parameters including blood flow （BF） , relative blood volume （rBV） , permeability （Pro） , and time of top peak （TrP） were created by body-perfusion software. The expressions of CD34 and VEGF in 39 cases who had operation were detected by LSAB immunohistochemistry staining, then the MVD counting and the expressions of YEGF were recorded. Results BF, rBV and Pm of malignant and the inflammatory groups were higher than those of the benign group （ P 〈 0.05 ）. No statistically significant differences in BF and rBV were found between the mafignant and the inflammatory （ P 〉 0.05 ）, but Pm of the malignant group was higher than that of the inflammatory group （ P 〈 0.05 ）. TTP of the benign group was higher than that of the malignant and the inflammatory group, but there was no statistically difference in TTP between the malignant and the inflammatory or between the inflammatory and the benign （ P 〉 0.05）. MVD and VEGF of the malignant and the inflammatory groups were higher than that of the benign group （ P 〈 0.05 ） , while no statistically significant difference was found between the malignant and the inflammatory （ P 〉 0.05 ）. rBV, BF and Pm was positively correlated with MVD and VEGF （ P 〈 0.05 ） in each group, but TTP were not related to MVD and VEGF （ P 〉 0.05 ）. Conclusion MSCT perfusion parameters have strong positive correlation with angiogensis in SPN and provide quantitative functional information about solitary pulmonary lesion, which are helpful for the differential diagnosis of solitary pulmonary lesion.