128层CT肺动脉造影+主动脉造影技术对周围型肺癌血供的研究价值

Value of CT angiography of pulmonary artery combined with angiography of aorta technology by 128-layer CT in evaluating blood supply of peripheral lung cancer

目的 :探讨128层CT肺动脉造影+主动脉造影技术对周围型肺癌血供的研究价值。方法 :从2012年9月至2014年9月间收治的经手术病理证实的周围型肺癌患者中,挑选出42例腺癌及鳞癌患者,分为3组,平均每组14例,第1组采用经验时间法延迟(16±2)s,后2组采用SMART技术触发式扫描,触发点分别为肺动脉主干及右心房中心层面,3组均采用一次屏气内完成肿瘤区肺动脉及胸主动脉期2期扫描;对比肺动脉、肺静脉及主动脉强化密度差异,统计分析肺动脉与主动脉在肺动脉及胸主动脉2期强化CT值绝对差值。结果:3组动脉期主动脉与肺动脉CT值绝对差值差异有统计学意义(均P<0.01),肺动脉期差异亦有统计学意义(均P<0.01)。第3组主动脉期与肺动脉期主动脉与肺动脉CT值绝对差值最大。结论:周围型肺癌患者采用右心房中心层面为扫描触发点,一次屏气完成肿瘤区肺动脉及胸主动脉期扫描,是一种比较成熟的128层CT肺动脉造影+主动脉造影革新式扫描方案,可准确采集相对纯肺循环期增强信息,对了解肿瘤有无肺动脉供血意义重大。

Objective：To discuss value of CT angiography of pulmonary artery combined with angiography of aorta technology by 128-layer CT in evaluating blood supply of peripheral lung cancer. Methods：42 cases with adenocarcinoma and squamous carcinoma were divided into three groups,each group of 14 cases. The first group had empirical method of time delay （16±2） s, the other two groups had SMART technology triggered scans ,trigger points were main pulmonary artery and right atrium center level,respectively. Three groups all completed two stage scanning of pulmonary artery and thoracic aorta within the tumor area in one breath-holding. Compared the enhancement density difference of the pulmonary artery and pulmonary vein and aorta ,by using statistical analysis method,contrast the absolute difference value of enhanced CT of pulmonary artery and aorta in each phase. Results：Significant difference exists in enhancement degree of thoracic aorta in pulmonary artery phase and that of pul-monary artery in aorta phase in three groups,with a highest difference in the third group,difference were statistically signifi-cance （P〈0.01）. Conclusions：Perform scanning of pulmonary artery and thoracic aorta within the tumor area in one breath-hold-ing using right atrium center as scanning trigger point in peripheral lung cancer ,is a comparatively mature and innovative scan-ning solutions of 128-layer CT angiography of pulmonary artery plus angiography of aorta. Accurate acquisition of enhancement information of relatively pure pulmonary circulation period is of great significance to know whether tumor has or has not pul-monary blood supply.