双源CT灌注成像诊断早期放射性肺损伤的应用价值

Role of dual source CT perfusion imaging in the diagnosis of early radiation-induced lung injury

目的探讨双源CT灌注成像早期诊断放射性肺损伤的应用效果,为放射性肺损伤早期诊断提供依据。方法观察放射性肺损伤患者45例(观察组)和未发生放射性肺损伤患者45例(对照组)的双源CT灌注成像灌注值的水平,同时对放射性肺损伤患者采用常规的CT检查,比较两种检测方法的灵敏度和准确度。结果观察组肺组织相对血流量(rr BF)、相对血容量(rr BV)、相对毛细血管通透性(rr PS)均显著高于对照组(P<0.05);观察组45例患者中的41例可诊断为放射性肺损伤,诊断的灵敏度、特异性分别为91.1%、97.78%,显著高于常规CT(P<0.01)。结论双源CT灌注成像能反映放疗后肺组织血液动力学的变化,能早期反映放射性肺损伤患者照射野的异常灌注,有可能成为早期检出放射性肺损伤的有效工具。

Objective To examine the role of dual source CT perfusion iraaging for early diagnosis of radiation-induced lung injury and to obtain scientific knowledge for early diagnosis of radiation induced lung injury. Method The level of dual source CT perfusion imaging perfusion values of the radiation-induced lung injury patients （ the experimental group, n = 45 ） and that of the patients with no radiation-induced lung injury （the control group, n= 45） was monitored. Meanwhile, the patients with radiation-induced lung injury were subjected to conventional CT examination. The sensitivity and accuracy of the two detection methods were then compared. Findings The values of lung tissue blood flow （rrBF） , relative blood volnme （rrBV）, relative blood capillary permeability （chip） of the experimental group were significantly higher than those of the control group （P0.05）. 41 of the 45 patients of the experimental group were diagnosed as cases of radioactive lung injury. The diagnostic sensitivity and specificity were 91. 1% and 97.78% respectively, which were significantly higher than those of the conventional CT technology （P 〈 0.01 ）. Conclusion Dual source CT perfusion imaging can display the changes after radiotherapy of lung hemodynamics and display early perfusion abnormalities in patients with radiation-induced lung injury, It can serve as an effective tool for early detection of radiation-induced lung injury.