CAJ | 학술논문

目的：探讨直径>3cm周围型肺癌螺旋CT动态增强扫描的血流动力学特点。材料与方法63例直径>3cm胸部孤立性病灶(其中50例肺癌、10例炎性病灶及3例胸腺瘤病例)行定点层面螺旋CT动态增强扫描，绘出病灶增强时间-密度曲线(TAC)，计算病灶最大增强线性斜率(SS)及血流灌注量(BP)。结果直径>3cm肺癌TAC表现为起始阶段曲线逐步上升，约60秒上升至峰值,然后缓慢下降。肺炎性病灶TAC表现为曲线起始段即呈快速上升，然后在上升至峰值的过程中出现少许的波动，120秒达峰值，然后下降。良性胸腺瘤的动态扫描密度变化较小，曲线较平稳。肺癌的平均SS及BP分别为4.91±4.68%/s，1.18±0.74ml/min.ml。肺炎性病灶的平均SS及BP分别为7.92±6.77%/s，1.90±0.97ml/min.ml，良性胸腺瘤的平均SS及BP分别为1.19±0.85%/s，BP为0.19±0.07ml/min.ml。结论螺旋CT动态增强扫描能反映直径>3cm周围型肺癌血流动力学特点，对其诊断与鉴别诊断有较大的临床价值。
목적：탐토직경>3cm주위형폐암라선CT동태증강소묘적혈류동역학특점。재료여방법63례직경>3cm흉부고립성병조(기중50례폐암、10례염성병조급3례흉선류병례)행정점층면라선CT동태증강소묘，회출병조증강시간-밀도곡선(TAC)，계산병조최대증강선성사솔(SS)급혈류관주량(BP)。결과직경>3cm폐암TAC표현위기시계단곡선축보상승，약60초상승지봉치,연후완만하강。폐염성병조TAC표현위곡선기시단즉정쾌속상승，연후재상승지봉치적과정중출현소허적파동，120초체봉치，연후하강。량성흉선류적동태소묘밀도변화교소，곡선교평은。폐암적평균SS급BP분별위4.91±4.68%/s，1.18±0.74ml/min.ml。폐염성병조적평균SS급BP분별위7.92±6.77%/s，1.90±0.97ml/min.ml，량성흉선류적평균SS급BP분별위1.19±0.85%/s，BP위0.19±0.07ml/min.ml。결론라선CT동태증강소묘능반영직경>3cm주위형폐암혈류동역학특점，대기진단여감별진단유교대적림상개치。
Objective To discuss the feature of hemodynamics of peripheral pulmonary carcinoma (diameter>3cm) by contrast enhanced spiral CT. MaterialsandMethods 63 cases with single focuses in lung(diameter>3cm, 50 cases with lung cancer, 10 cases with inflammatory lesions and 3 cases with thymus tumor) were performed with contrast enhanced spiral CT. The patterns of time-attenuation curve(TAC) were drawn. Steeps slope(SS) and blood perfusion(BP) were calculated. Results The main pattern of TAC of pulmonary carcinoma showed a slowed rise at the beginning and rise to the peak height at about 60s, and then fell slowly. The main pattern of TAC of pulmonary inflammatory nodules showed a rapid rise at the beginning and a little fluctuation during the rise to peak height at 120s, and then the fall. The main pattern of TAC of benign thymus tumor was smooth. The SS, BP of pulmonary carcinoma were 4.91±4.68%/s and 1.18±0.74ml/min.ml. The SS, BP of inflammatory nodules were 7.92±6.77%/s and 1.90±0.97ml/min. ml. The SS, BP of benign thymus tumor were 1.19±0.85%/s and 0.19±0.07ml/min. ml. Conclusion Contrast enhanced spiral CT could provide hemodynamic information of peripheral pulmonary carcinoma (diameter>3cm) and has important clinical value in the diagnosis and treatment of pulmonary carcinoma.