多排螺旋CT灌注成像在涎腺肿块鉴别诊断中的应用

Application study of time density curve in salivory gland tumors with multidetector-row CT perfusion imaging

目的探讨64排CT灌注成像技术定量评价涎腺良、恶性肿块的血液流变学特点及其对涎腺良、恶性肿块的鉴别诊断价值。方法30例患者中良性肿块15例,恶性肿块10例,炎性包块5例(6个病灶),全部经术后病理证实。术前均行CT灌注检查。绘制肿块的时间-密度曲线(TDC),并取得灌注参数:血流量(BF),血容量(BV),平均通过时间(MTT)和表面渗透性(PS)。结果CT灌注参数的BF、PS、BV值在涎腺肿块中表现为恶性组>炎性组>良性组,且3组间差异有统计学意义(P<0.05),而MTT值差异无统计学意义(P>0.05)。组间两两比较,恶性组与良性组、良性组与炎性组的BF、PS、BV值比较差异均有统计学意义(P<0.05),MTT值差异无统计学意义(P>0.05);恶性组与炎性组的BF、PS、BV、MTT值比较差异均无统计学意义(P>0.05)。良性肿块、恶性肿块及炎性肿块的TDC形态不同。结论CT灌注成像技术可以反映涎腺肿块的血液流变学特点,在判断肿块的性质上具有一定临床应用价值。

Objective To explore 64-slice SCT perfusion imaging in quantitatively judging the blood patterns of the benign and the malignancies masses of the salivory gland,and to evaluate its clinical value in differentiating benign masses from malignant masses of the salivory gland.Methods Thirty patients were included in this study （15 with benign masses,10 with maligant masses and 5 with inflammatory masses）.All the masses were conformed by histopathological and examined with CT perfusion before operations.To render the mass time density curve and acquire parameter of perfusion,including：blood flow（BF）,blood volume（BV）,mean transit time（MTT）,permeability surface（PS）.Results Malignant masses showed significant higher value of BF,PS and BV than those of inflammatory masses.And inflammatory masses also showed significant higher value of BF,PS and BV than those of benign masses in salivary gland masses.There was significant difference in BF,PS and BV between three groups（P〈0.05）,but there was no significant difference in MTT（P〉0.05）.Multiple comparison among three groups,except for MTT,the difference of parameters perfusion BF,PS and BV between benign and malignant masses were statistically significant（P〈0.05）.There was no significant difference in BF,PS,BV and MTT between malignant masses and inflammatory masses（P〉0.05）.There were different forms of TDC among three groups.Conclusion On the basis of this study,the parameters of CT perfusion,BF,BV,PS and TDC are valuable in differential diagnosis for benign and malignant masses of the salivary gland.