多层螺旋CT灌注成像对外周型小结节状肺腺癌淋巴结转移的诊断价值

Diagnostic value of multi-slice spiral CT perfusion imaging on lymph node metastasis of peripheral nodular pulmonary adenocarcinoma

目的探讨多层螺旋CT灌注成像对外周型小结节状肺腺癌淋巴结转移的诊断价值。方法选取2014年4月~2015年10月我院就诊的320例外周型小结节状肺腺癌患者为研究对象,所有患者均进行多层螺旋CT灌注成像,采用元相关分析的手段,探讨患者多层螺旋CT灌注成像参数:强化峰值(PEI)、血容量(BV)、血流量(BF)和患者淋巴结转移以及术后复发转移的关系。结果 320例研究对象中,201例有淋巴结转移,119例无淋巴结转移,有淋巴结转移组的强化峰值(PEI)、血容量(BV)、血流量(BF)均显著低于无淋巴结转移组,差异有统计学意义(P<0.05);随访2年后,119例无淋巴结转移的患者中,87例出现复发转移,32例无复发转移,有复发转移组的强化峰值(PEI)、血流量(BF)均显著低于无复发转移组,差异有统计学意义(P<0.05);有复发转移组的血容量(BV)和无复发转移组无显著差异(P>0.05)。结论多层螺旋CT灌注成像能有效预测外周型小结节状肺腺癌淋巴结转移和术后转移复发情况,具有临床指导意义,值得临床推广应用。

Objective To investigate the diagnostic value of multi-slice spiral CT perfusion imaging on lymph node metastasis of peripheral nodular pulmonary adenocarcinoma. Methods 320 patients with peripheral nodular pulmonary adenocarcinoma in our hospital from April 2014 to October 2015 were selected. All patients went through multi-slice spiral CT perfusion imaging. Meta correlation analysis was used to investigate the associations of indices of multi-slice spiral CT perfusion imaging[peak enhancement image （PEI）, blood volume （BV） and blood flow （BF）]with lymph node metastasis and postoperative metastasis and recurrence. Results Out of 320 subjects, 201 patients were with lymph node metastasis and 119 patients were without lymph node metastasis. PEI, BV and BF of patients with lymph node metastasis were significantly lower than those of patients without lymph node metastasis（P〈0.05）. After 2-year follow-up, out of 119 patients without lymph node metastasis, metastasis and recurrence were observed in 87 patients and 32 patients were still without metastasis or recurrence. Among these patients, PEI, BF of patients with metastasis and recurrence were significantly lower than those of patients without metastasis or recurrence（P〈0.05） while the values of BV- in two groups of patients were not significantly different （P〉0.05）. Conclusion Multi-slice spiral CT perfusion imaging could predict the lymph node metastasis and postoperative metastasis and recurrence in patients with peripheral nodular pulmonary adenocarcinoma. It was worth clinical promotion and application.