64层VCT首过期灌注成像对肺部结节的诊断价值

First pass phase of perfusion imaging with 64-slice VCT in diagnosis of pulmonary nodules

目的:探讨首过期的64层VCT肺灌注成像对肺部结节的诊断意义。方法:对108例肺结节患者进行CT灌注扫描,测定肺结节的时间-密度曲线(TDC)、血容积(BV)、血流量(BF)、平均通过时间(MTT)和表面通透性(PS)的数值,并测量肺结节增强前的CT值、增强值和结节-动脉增强值之比(S/A)。标定结节的血管内皮生长因子(VEGF),评价肺结节CT灌注和增强指数与VEGF表达的相关性。结果:肺癌的灌注指数高于肺良性结节。良、恶性结节的TDC形态不同。结论:CT肺灌注成像可定量的评价肺结节的血流灌注特点,对肺部结节有较大的诊断及鉴别诊断意义。

Objective：To evaluate the diagnostic ability of first pass phase of perfusion imaging with 64-slice VCT between benign and malignant pulmonary nodules.Methods：A total of 108 patients with pulmonary nodules underwent perfusion scan with 64 slice spiral CT scanner.The parameters of CT perfusion,including blood volume（BV）,blood flow（BF）,mean transit time（MTT）,permeability surface（PS）,and time-density curve（TDC）,were analyzed.The CT perfusion and enhanced parameters were compared with vascular endothelial growth factor（VEGF） expression by immunohistochemistry.Results：These parameter values in pulmonary malignancy nodules were highter than those in pulmonary benign nodules.The TDC appeared different for malignant and benign nodules.Conclusion：Perfusion CT can provide quantitative information about blood flow perfusion of nodules and it is meaningful to the diagnosis and differential diagnosis of pulmonary nodules.