CAJ | 학술논문

目的：研究比较64层CT灌注成像对于孤立性肺结节(SPN)良恶性的诊断价值及临床应用。方法对于我院2011年11月至2013年11月50例未经治疗的直径≤3cm的肺孤立结节根据病理结果分为恶性结节组和良性结节组，分别进行64层螺旋CT灌注成像，计算结节的血流量(BF)、血容量(BV)、平均通过时间(MTT)和通透性值(PS)。同时绘制同层面结节的时间-密度曲线(TDC)，判断结节良恶性，和手术病理结果进行对比分析，计算各灌注参数对于孤立性肺结节良恶性诊断的准确率、敏感性和特异性。结果经CT引导下肺穿刺活检或手术病理证实，发现恶性结节34例，良性结节16例。两组结节的各灌注参数差异显著， P<0.01；同层面结节的TDC曲线良恶性差异显著，有助于提示结节性质，血容量(BV)、平均通过时间(MTT)、血流量(BF)和通透性值(PS)对于孤立性肺结节良恶性诊断的准确率、敏感性和特异性分别为88%，88.24%，87.50%；90%，94.12%，81.25%；94.00%，91.12%，100.00%；86.00%，94.12%，68.75%。结论64层CT灌注成像技术有助于早期诊断孤立性肺结节性质，为进一步治疗方案提供思路。
목적：연구비교64층CT관주성상대우고립성폐결절(SPN)량악성적진단개치급림상응용。방법대우아원2011년11월지2013년11월50례미경치료적직경≤3cm적폐고립결절근거병리결과분위악성결절조화량성결절조，분별진행64층라선CT관주성상，계산결절적혈류량(BF)、혈용량(BV)、평균통과시간(MTT)화통투성치(PS)。동시회제동층면결절적시간-밀도곡선(TDC)，판단결절량악성，화수술병리결과진행대비분석，계산각관주삼수대우고립성폐결절량악성진단적준학솔、민감성화특이성。결과경CT인도하폐천자활검혹수술병리증실，발현악성결절34례，량성결절16례。량조결절적각관주삼수차이현저， P<0.01；동층면결절적TDC곡선량악성차이현저，유조우제시결절성질，혈용량(BV)、평균통과시간(MTT)、혈류량(BF)화통투성치(PS)대우고립성폐결절량악성진단적준학솔、민감성화특이성분별위88%，88.24%，87.50%；90%，94.12%，81.25%；94.00%，91.12%，100.00%；86.00%，94.12%，68.75%。결론64층CT관주성상기술유조우조기진단고립성폐결절성질，위진일보치료방안제공사로。
Objective Comparative study of 64 slice CT perfusion imaging in solitary pulmonary nodules (SPN) and clinical application value in diagnosis of benign andmalignant. Methods For November to 2013 November in our hospital in 2011 50 cases of untreated diameter ≤ 3cm in solitary pulmonary nodules based on the pathological findings were divided into malignant nodules group andbenign SPNs group, respectively with 64 slice spiral CT perfusion imaging, bloodflowcalculation nodules (BF), bloodvolume (BV), theaverage pass time (MTT) and permeability value (PS). At the same time,rendering the same level nodules of time density curve (TDC),differentiating the benign and malignant nodules, and operation and pathology results were compared and analyzed, calculated the perfusion parameters for accuracy, diagnosis of malignant solitary pulmonarynodules sensitivity and specificity. Results He CT guided lung biopsy or operation and confirmed by pathology,found 34 cases of malignant nodules, 16 cases with benign nodules. Theperfusion parameters between two groups nodule significantly, P<0.01;TDC curve level with the benign and malignant nodules differ significantly, helps to prompt nodules (BV), blood volume, mean transit time (MTT), blood flow (BF) and permeability values (PS) for benign and malignant solitary pulmonary nodules, accuracy diagnostic sensitivityandspecificitywere 88%, 88.24%, 87.50%; 90%, 94.12%, 81.25%;94%,91.12%, 100%; 86%, 94.12%, 68.75%. Conclusion 64 slice CT perfusion imaging is helpful to early diagnosis of solitary pulmonary nodules, provide ideas for further treatment.