周围型肺癌双排螺旋CT灌注成像研究

Study on the double CT perfusion imaging in the diagnosis of milieu pulmonary cancer

目的探讨双排螺旋CT灌注成像在孤立性外周肺结节良性、炎性、恶性的诊断及鉴别诊断的意义。方法利用双排螺旋CT灌注成像技术研究50例直径2～5cm的孤立性外周肺结节灌注表现,采用CTperfusion胸部肿瘤灌注软件包,测定肺内病灶的血容量(BV)、血流量(BF)、对比剂到达峰值的时间(TTP)、强化峰值(PEI)和时间-密度曲线(TDC),并在其基础上计算出强化值、孤立性外周肺结节与主动脉增强峰值之比值(S/A)。结果恶性结节和炎性结节的BF、BV和PEI值均明显高于良性结节(P<0.05),恶性结节和炎性结节之间的灌注值则差异无统计学意义(P>0.05),恶性结节、良性结节和炎性结节的时间-密度曲线(TDC)均显示形态不同。恶性结节和炎性结节强化值、S/A值高于良性结节(P<0.05)。结论双排螺旋CT灌注成像有助与良恶性肺结节的诊断及鉴别诊断。

Objective To evaluate value of CT perfusion imaging in diagnosing the milieu solitary pulmonary nodule（SPN）.Methods 50 patients with SPN（2-5cm in diameter）were study with CT perfusion imaging using double-slice CT.The CT perfusion imaging features were analyzed with tumor s perfusion software.The blood volume（BV）,blood flow（BF）,time to peak（TTP）,peak enhancement intensity（PEI）and time-density curve（TDC）of the lesions were measured,and the enhanced values and SPN/aorta in PEI（S/A）of lesions were calculated.Results There were significant differences in BF, BV and PEI between malignant and benign nodus （P 〈 0. 05） . There were no differences in perfusion values among malignant, begin and inflammatory nodus （ P 〉0.05）. The TDC showed different shapes among malignant, benign and inflammatory nodus. The enhanced values and S/A of malignant and inflammatory nodus significant differences （ P 〈 0. 05 ）. Conclusion differential diagnosis of SPN. were higher than those of benign nodus, and there were Double CT perfusion is valuable for the diagnosis and differential diagnosis of SPN.