CAJ | 학술논문

目的：探讨肺部孤立性病变多层螺旋CT （MSCT ）灌注成像参数与肿瘤微血管密度（MVD ）间的关系，评价MSCT灌注成像对肺部孤立性病变的鉴别诊断价值。方法：80例经病理证实的肺部孤立性病变患者行 MSCT 灌注成像检查，计算血流量（BF）、血容量（BV）、平均通过时间（MTT）、毛细血管通透性（PS）；采用CD34单抗标记测定 MVD，分析良、恶性病变、炎性病变、不同分化程度肿瘤组织的CT灌注参数差异及各参数与 MVD间的相关性。结果：良、恶性和炎性病变组的BV分别为（3．45±1．75）、（10．40±4．08）、（8．40±8．42）mL/100g；BF 分别为（24．48±18．74）、（77．75±43．03）、（84．54±107．13）mL/（100g·min）；PS分别为（4．33±2．90）、（21．70±10．86）、（14．67±10．29）mL/（100g·min）；MTT分别为（15．54±7．01）、（15．23±13．35）、（12．55±8．39）s。良性组与恶性组、良性组与炎性组BF、BV、PS值差异均具有统计学意义（P＜0．05）；恶性组与炎性组间仅 PS 差异具有统计学意义（P＜0．05），MTT 均无相关性（P＞0．05）。MVD在非小细胞肺癌不同分化程度鉴别方面具有统计学意义。BF、BV、PS与 MVD呈正相关（P＜0．05），MTT与 MVD无相关性（P＞0．05）。结论：MSCT灌注成像可间接反映活体肺部孤立性病变血管生成情况，为鉴别肺部孤立性病变良恶性和治疗、预后评估提供依据。
목적：탐토폐부고립성병변다층라선CT （MSCT ）관주성상삼수여종류미혈관밀도（MVD ）간적관계，평개MSCT관주성상대폐부고립성병변적감별진단개치。방법：80례경병리증실적폐부고립성병변환자행 MSCT 관주성상검사，계산혈류량（BF）、혈용량（BV）、평균통과시간（MTT）、모세혈관통투성（PS）；채용CD34단항표기측정 MVD，분석량、악성병변、염성병변、불동분화정도종류조직적CT관주삼수차이급각삼수여 MVD간적상관성。결과：량、악성화염성병변조적BV분별위（3．45±1．75）、（10．40±4．08）、（8．40±8．42）mL/100g；BF 분별위（24．48±18．74）、（77．75±43．03）、（84．54±107．13）mL/（100g·min）；PS분별위（4．33±2．90）、（21．70±10．86）、（14．67±10．29）mL/（100g·min）；MTT분별위（15．54±7．01）、（15．23±13．35）、（12．55±8．39）s。량성조여악성조、량성조여염성조BF、BV、PS치차이균구유통계학의의（P＜0．05）；악성조여염성조간부 PS 차이구유통계학의의（P＜0．05），MTT 균무상관성（P＞0．05）。MVD재비소세포폐암불동분화정도감별방면구유통계학의의。BF、BV、PS여 MVD정정상관（P＜0．05），MTT여 MVD무상관성（P＞0．05）。결론：MSCT관주성상가간접반영활체폐부고립성병변혈관생성정황，위감별폐부고립성병변량악성화치료、예후평고제공의거。
Objective:To observe the correlation between MSCT perfusion parameters and microvessel density (MVD),and to evaluate the diagnostic value of CT perfusion in differentiating the solitary pulmonary lesions.Methods:80 cases of solitary pulmonary lesions proved by pathology underwent CT perfusion.Blood flow(BF),blood volume (BV), mean transit time(MTT)and permeability surface(PS)were caculated.To measure the MVD using CD34 labeled mono-clonal antibody.To compare MSCT perfusion parameters between malignant tumors of different grades,benign,malignant and inflammatory lesions.To analyse the correlation between MSCT perfusion parameters and MVD.Results:The BF value of benign,malignant and inflammatory lesions was (3.45± 1.75)、(10.40±4.08)、(8.40±8.42)mL/100g,respectively;the BV value was (24.48±18.74)、(77.75±43.03)、(84.54±107.13)mL/(100g·min),respectively;the PS value was (4.33±2.90)、(21.70±10.86)、(14.67±10.29)mL/(100g·min),respectively;the MTT value was (15.54±7.01)、(15.23±13.35)、(12.55±8.39)s,respectively;The differences of BF,BV,PS between benign and malignant lesions,be-nign and inflammatory lesions were statistically significant(P<0.05).Only the difference of PS between malignant and in-flammatory lesions was statistically significant(P<0.05).There were no significant differences in MTT between the three groups (P>0.05).There was statistically difference in MVD between different grades of non-small cell lung cancer (P<0.05).BF、BV、PS were positive correlated with MVD (r= 0.316,0.886,0.617,P<0.05).There was no correlation be-tween MTT and MVD (P>0.05).Conclusion:MSCT perfusion can reflected the angiogenesis of solitary pulmonary lesions in vivo inderectly,and can provide evidences for the differential diagnosis,optimization of a reasonable treatment protocol, the evaluation of curative effect and the prognosis.