海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
16期
2385-2388
,共4页
孙琼芳%涂蓉%张业雨%李胜达%王圣恩%史华莉%尤晓光%伍保忠
孫瓊芳%塗蓉%張業雨%李勝達%王聖恩%史華莉%尤曉光%伍保忠
손경방%도용%장업우%리성체%왕골은%사화리%우효광%오보충
CT灌注%肺癌%诊断
CT灌註%肺癌%診斷
CT관주%폐암%진단
CT perfusion%Lung cancer%Diagnosis
目的：探讨CT灌注成像对肺癌的临床诊断价值。方法选择临床鉴别诊断困难，可疑肺肿瘤的47例孤立性肺结节患者做CT灌注检查，按入选标准共有20例纳入研究。先行常规CT扫描，确定肺肿瘤中心部位，对选定肿瘤层面行灌注成像，包括组织的时间-密度曲线(Time-density curve，TDC)、血流量(Blood flow，BF)、血容量(Blood volume，BV)、对比剂平均通过时间(Mean transit time，MTT)、表面通透性(Permeability surface，PS)等参数，以此来评价并定量地反映孤立性肺结节的血流灌注状态。结果孤立性肺结节的恶性与良性病变BV、MTT、BF、PS经分别进行两样本独立t检验，四组差异均有统计学意义(P<0.01)；恶性病变BV、BF、PS明显高于良性病变，而MTT明显低于良性病变。比较传统CT常规扫描方法和CT灌注检查对孤立性肺结节的术前诊断准确率，分别为70%和95%，经χ2检验，其差异有统计学意义(P<0.05)，显示CT灌注检查诊断符合率更高。结论 CT灌注能反映出孤立性肺结节的血流特点，其结合肺结节常规CT扫描的形态学特征能为肺癌的临床诊断提供重要依据，对临床治疗方案制定起到积极的指导作用。
目的：探討CT灌註成像對肺癌的臨床診斷價值。方法選擇臨床鑒彆診斷睏難，可疑肺腫瘤的47例孤立性肺結節患者做CT灌註檢查，按入選標準共有20例納入研究。先行常規CT掃描，確定肺腫瘤中心部位，對選定腫瘤層麵行灌註成像，包括組織的時間-密度麯線(Time-density curve，TDC)、血流量(Blood flow，BF)、血容量(Blood volume，BV)、對比劑平均通過時間(Mean transit time，MTT)、錶麵通透性(Permeability surface，PS)等參數，以此來評價併定量地反映孤立性肺結節的血流灌註狀態。結果孤立性肺結節的噁性與良性病變BV、MTT、BF、PS經分彆進行兩樣本獨立t檢驗，四組差異均有統計學意義(P<0.01)；噁性病變BV、BF、PS明顯高于良性病變，而MTT明顯低于良性病變。比較傳統CT常規掃描方法和CT灌註檢查對孤立性肺結節的術前診斷準確率，分彆為70%和95%，經χ2檢驗，其差異有統計學意義(P<0.05)，顯示CT灌註檢查診斷符閤率更高。結論 CT灌註能反映齣孤立性肺結節的血流特點，其結閤肺結節常規CT掃描的形態學特徵能為肺癌的臨床診斷提供重要依據，對臨床治療方案製定起到積極的指導作用。
목적：탐토CT관주성상대폐암적림상진단개치。방법선택림상감별진단곤난，가의폐종류적47례고립성폐결절환자주CT관주검사，안입선표준공유20례납입연구。선행상규CT소묘，학정폐종류중심부위，대선정종류층면행관주성상，포괄조직적시간-밀도곡선(Time-density curve，TDC)、혈류량(Blood flow，BF)、혈용량(Blood volume，BV)、대비제평균통과시간(Mean transit time，MTT)、표면통투성(Permeability surface，PS)등삼수，이차래평개병정량지반영고립성폐결절적혈류관주상태。결과고립성폐결절적악성여량성병변BV、MTT、BF、PS경분별진행량양본독립t검험，사조차이균유통계학의의(P<0.01)；악성병변BV、BF、PS명현고우량성병변，이MTT명현저우량성병변。비교전통CT상규소묘방법화CT관주검사대고립성폐결절적술전진단준학솔，분별위70%화95%，경χ2검험，기차이유통계학의의(P<0.05)，현시CT관주검사진단부합솔경고。결론 CT관주능반영출고립성폐결절적혈류특점，기결합폐결절상규CT소묘적형태학특정능위폐암적림상진단제공중요의거，대림상치료방안제정기도적겁적지도작용。
Objective To assess the clinical value of CT perfusion imaging in diagnosing lung can-cer. Methods Forty-seven solitary pulmonary nodules patients with difficult differential diagnoses and suspicious lung tumor were chosen to receive CT perfusion examination. A total of 20 patients were selected according to the in-clusion criteria. Those patients received regular CT scan at first and the center of lung cancer was located. Then, CT perfusion scan at the chosen lay was carried out. The parameters of CT perfusion were calculated by GE CT perfusion software, including Time-density curve (TDC), blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface (PS). The blood perfusion of solitary pulmonary nodules was evaluated and quantificationally re-flected by these parameters. Results BV, MTT, BF, PS in malignant and benign solitary pulmonary nodules were ana-lyzed by double-sample independent T test with statistically significant (P<0.01). BV, BF, PS of malignant solitary pul-monary nodules were significantly higher than that of benign solitary pulmonary nodules, while MTT was significant-ly lower than that of benign solitary pulmonary nodules. The accuracy rate of diagnosis of conventional CT scan and CT perfusion imaging were compared, which were 70% and 95% respectively. The value was evaluated by χ2 test, which showed that the accuracy rate of diagnosis of CT perfusion imaging was significantly higher than that of con-ventional CT scan. Conclusion CT perfusion can reflect the blood-flow characteristics of solitary pulmonary nod-ules. Combined with morphological characteristics of pulmonary nodules by regular CT scan, CT perfusion imaging can provide important bases for the diagnosis of lung cancer and guide clinical treatment.
