Ⅰ期周围型肺腺癌CT灌注成像临床研究

The clinical study of multi-slice spiral CT pulmonary perfusion imaging in clinical stage Ⅰ peripheral lung adenocarcinoma

目的探讨MSCT灌注成像评价临床Ⅰ期周围型肺腺癌影像特征的价值。方法对72例患者行MSCT灌注扫描,用多元相关分析探讨灌注参数与影像特征的关系,再分组进行趋势检验。结果灌注参数与周围型肺腺癌影像特征相关,血流量(BF)和强化峰值(PEI)随分化程度减低而降低(P值分别为0.01与0.024);有淋巴结转移组的BF和PEI明显低于无淋巴结转移组(P值分别为0.000与0.003);术后转移组BF值明显低于未转移组(P=0.000)。结论 MSCT灌注成像通过无创性评价血管生成的方式和程度,间接反映肿瘤分化程度,从而预测淋巴结转移和术后转移的可能性,是判断周围型肺腺癌生物学行为及预后的良好指标。

Objective To discuss the role of multi-slice spiral CT pulmonary perfusion imaging in the clinic image features of clinical stage Ⅰ peripheral lung adenocareinoma. Methods 72 patients of peripheral lung adenocareinoma received CT perfusion. The correlation analysis was made between CTP parameters and clinic image features. The relationship between the CTP parameters and lymph nodes metastases, histological types, differentiation, postoperative metastasis were analyzed using the trend test. Results There were correlations between CTP parameters and the clinic image features in peripheral lung adenocarcinoma. The BF and PEI decreased with decreasing differentiation of peripheral lung adenocarcinoma, comparison between groups showed that BF of well differentiated was higher than that of moderate or poor differentiation, PEI of well or moderate differentiated was higher than that of poor differentiation （ P 〈0.05）. The BF and PEI of lymph node metastasis positive group was higher than that of negative group （ P 〈 0.01）. The BF of metastasis of postoperation positive group was higher than that of negative group （ P 〈0.01）. Conclusion The multi-slice spiral CT pulmonary perfusion imaging indirectly and nominvasively can reflect the differentiation of peripheral lung adenocarcinoma by evaluating the model of angiogenesis, then predict the possibility of postoperative metastasis. The multi-slice spiral CT pulmonary perfusion imaging can be used as a useful markers to judge the biological behavior and the prognosis of peripheral lung adenocareinoma.