CT灌注成像在颈部恶性淋巴结鉴别诊断中的应用

CT Perfusion Imaging in Differential Diagnosis of Malignant Lymph Nodes in Head and Neck

目的探讨CT灌注区分不同病理类型颈部淋巴结的价值。方法对39例颈部恶性淋巴结病变患者行CT灌注,测量并比较不同病理类型淋巴结的血流量(BF)、血容量(BV)、渗透性(P值)灌注参数及TDC曲线。结果原发组、转移组淋巴结BF、BV、P值均大于正常组(P<0.05);继发组淋巴结BF、BV大于原发组(P<0.05)。原发组以"低平"型为主,表现为缓慢上升到一较高的峰值后,在峰值水平呈水平走势;转移组以"快升快降"型为主,主要表现为快速上升到达峰值后会又快速下降形成一波峰。结论颈部恶性淋巴结与正常淋巴结及不同病理类型恶性淋巴结灌注特点不同,利用CT灌注结合CT形态学表现可以提高对颈部淋巴结病变诊断水平。

Objective To evaluate the value of dynamic CT perfusion in diagnosis various cervical lymph nodes in head and neck.Methods The dynamic perfusion series were performed for in 37 patients with cervical lymph node leisions,.The time-density curve（TDC） and the date of their perfusion parameters were recorded and analyzed statistically.Results The BF,BV,P of primary and metastatic lymph nodes were higher than their of normal lymph nodes（P0.05）.The BF,BV of metastatic lymph nodes higher than their of primary lymph nodes（P0.05）.The TDC of primary lymph nodes show low level curve.The TDC of metastatic lymph nodes presented rapid ascending and rapid descending.Conclusion The parameters and the TDC of CT perfusion among the lymph nodes have some characteristic,it is useful to diagnose the lymph nodal diseases.