双入口CT灌注技术评价周围型肺癌血供特性

Dual-input CT perfusion in assessing blood supply of peripheral lung cancer

目的应用双入口CT灌注（DI-CTP）测量技术评价周围型肺癌的血供特征。方法收集周围型肺癌患者30例，对所有患者行肺部CT灌注扫描，以肺动脉干和降主动脉作为肺循环和体循环输入动脉，以左心房峰值时间点作为肺循环、体循环分界线，采用DI-CTP模式处理数据获得肺动脉血流量（PF）、支气管动脉血流量（BF）和灌注指数（PI），分析肿瘤灌注特点及其与肿瘤最大径的相关性。结果28例（28／30，93.33%）以支气管动脉血流为主，肿瘤最大径2.2～5.5cm，PF为（17.01±8.24）ml／（min·100m1），BF为（50.06±15.25）ml／（min·100m1），PI为0.24±0.07，BF明显大于PF（P〈0.05）；2例（2／30，6.67％）以肺动脉血流为主，肿瘤最大径分别为1.2cm和1.6cm，PF分别为22.22ml／（min·100m1）和85.20ml／（min·100m1），BF分别为9.88ml／（min·100m1）和22.05ml／（min·100m1），P1分别为0.64和0.65。PI与肿瘤最大径呈负相关（r=—0.87，P〈0.05）。结论周围型肺癌肺循环、体循环同时存在，多以体循环为主，利用DI-CTP技术可定量评价其血供特征。

Objective To evaluate the blood supply characteristics of the peripheral lung cancer using dual-input CT perfusion method （DI-CTP）. Methods Totally 30 patients with peripheral lung cancer proved by pathology underwent volume perfusion CT imaging of the lung. The pulmonary trunk and the descending aorta was respectively selected as input arteries for the pulmonary circulation and the bronchial circulation, and the peak time point of left atrium was regarded as boundary of the pulmonary circulation and the bronchial circulation. Pulmonary flow （PF）, bronchial flow （BF） and perfusion index （PI） were obtained. The perfusion chracteristics of the tumor and the correlation with the tumor size were analyzed. Resuits In 28 patients （28/30, 93.33%）, the tumors were mainly fed by bronchial circulation with maximum diameter of 2.2-5.5 cm. The PF was （17.01±8.24） ml/（min·100 ml）, the BF was （50.06±15.25）ml/（min·100 ml）, the PI was 0.24±0.07, and BF was significantly larger than PF （P〈0.05）. In 2 patients （2/30, 6.67%）, the tumors were mainly fed by pulmonary circulation with maximum diameter of 1.2 cm and 1.6 cm. The PF was 22.22 ml/（min·100 ml） and 85.20 ml/（min·100 ml）, the BF was 9.88 ml/（min·100 ml） and 22.05 ml/（min·100 ml）, the PI was 0.64 and 0.65. There was a negative correlation between maximal diameter of the tumor and PI （r=—0.87, P〈0.05）. Conclusion Peripheral lung cancer shows characteristics of dual blood supply, and the systemic circulation is dominant in most of the patients, which can be detected by DI-CTP.