CAJ | 학술논문

目的：分析双源CT支气管动脉血管造影显示的肺癌特异血管征象；通过经验法和智能追踪两种扫描模式探讨血管期最佳延迟扫描时间。方法前瞻性挑选2012年10月至2013年10月在我院行双源CT胸部增强的患者128例，分为肺癌组和对照组，每组病例血管期延迟扫描时间分别采用经验法（20s）和自动触发（Bolus－tracking ）方式确定。将不同方式获得的血管期原始图像采用容积再现（ volume rendering ， VR）、最大密度投影（ maximum intensity projection ，M IP）、多平面重建（ multiplanar reconstruction ，M PR），曲面重建（Curved Planar Reformation ，CPR）等技术进行后处理。结果肺癌组采用自动触发模式扫描的34例中，2例两侧支气管动脉均未显示。经验法扫描的34例中，4例两侧支气管动脉均未显示，两种扫描方式支气管动脉的显示率分别为94．12％和88．24％。二者差异无统计学意义（P＝0．6690）。对照组两种扫描方式支气管动脉显示率分别为63．33％和60．00％，二者差异也无统计学意义（P＝0．7906）。但是相同扫描模式下肺癌组和对照组显示率差异有统计学意义，肺癌组显示率明显高于对照组。肺癌组中共有20例形成瘤血管，5例表现为蚓状，8例表现为斑点状，3例表现为网状，4例表现为血湖状强化。肺癌组采用自动触发扫描模式的34例血管期延迟扫描时间为（20．71±1．12）s。结论肺癌的瘤血管征具有较高特异性，这些征象在良性病变中未见显示；采用智能追踪和经验法20 s两种扫描模式所获得血管期图像对肺癌相关特异血管征象的显示无明显差别；通过统计分析得到肺癌组智能追踪模式的血管期延迟时间为（20．71±1．12）s。
목적：분석쌍원CT지기관동맥혈관조영현시적폐암특이혈관정상；통과경험법화지능추종량충소묘모식탐토혈관기최가연지소묘시간。방법전첨성도선2012년10월지2013년10월재아원행쌍원CT흉부증강적환자128례，분위폐암조화대조조，매조병례혈관기연지소묘시간분별채용경험법（20s）화자동촉발（Bolus－tracking ）방식학정。장불동방식획득적혈관기원시도상채용용적재현（ volume rendering ， VR）、최대밀도투영（ maximum intensity projection ，M IP）、다평면중건（ multiplanar reconstruction ，M PR），곡면중건（Curved Planar Reformation ，CPR）등기술진행후처리。결과폐암조채용자동촉발모식소묘적34례중，2례량측지기관동맥균미현시。경험법소묘적34례중，4례량측지기관동맥균미현시，량충소묘방식지기관동맥적현시솔분별위94．12％화88．24％。이자차이무통계학의의（P＝0．6690）。대조조량충소묘방식지기관동맥현시솔분별위63．33％화60．00％，이자차이야무통계학의의（P＝0．7906）。단시상동소묘모식하폐암조화대조조현시솔차이유통계학의의，폐암조현시솔명현고우대조조。폐암조중공유20례형성류혈관，5례표현위인상，8례표현위반점상，3례표현위망상，4례표현위혈호상강화。폐암조채용자동촉발소묘모식적34례혈관기연지소묘시간위（20．71±1．12）s。결론폐암적류혈관정구유교고특이성，저사정상재량성병변중미견현시；채용지능추종화경험법20 s량충소묘모식소획득혈관기도상대폐암상관특이혈관정상적현시무명현차별；통과통계분석득도폐암조지능추종모식적혈관기연지시간위（20．71±1．12）s。
Objective To investigate the clinical value of highly specific tumor vascular symptoms in the early diagnosis of lung cancer .Assess the display capabilities of specific tumor vascular symptoms with the experi-ence method and bolus-tracking .To further explore the optimalscan time of vascular phase .Methods 1 2 8 cas-es were examined with enhanced Dual-Source computed tomography ,the data were grouped primary lung can-cer patients and healthy subjects .Each case were used empirical method (2 0 s) and bolus-tracking to determine the scan time of vascular phase .The original image were processed at the workstation using volume render(VR) and multiplanar reconstruction (MPR) or maxmum intensity projection (MIP) and curved Planar Reformation (CPR) .Result A total of 3 4 Lung cancer patients used bolus-tracking ,2 cases of bronchial arteries did not show .A total of 3 4 Lung cancer patients used experience method ,4 cases of bronchial arteries did not show . Two scanning display rate of bronchial arteries is 9 4 .1 2% and 8 8 .2 4% respectively has not a significant differ-ence( P=0 .6 6 9 0 ) .In healthy subjects ,two scanning display rate of bronchial arteries is 6 3 .3 3% and 6 0 .0 0%respectively has not a significant difference ( P= 0 .7 9 0 6 ) ,but at the same scanning ,lung cancer patients and healthy subjects has a significant difference ,lung cancer group showed significantly higher .In 20 cases that formed tumor blood vessels ,5 cases showed earthworm-like ,8 cases showed patchy ,3 cases showed mesh and 4 cases showed blood lake-like enhancement .Bolus-tracking of lung cancer patients scan time of vascular phase is(2 0 .7 1 ± 1 .1 2 )s .Conclusion Tumor vascular symptoms of lung cancer with higher specificity ;two scanning display rate of bronchial arteries has not a significant difference;bolus-tracking of lung cancer patients scan time of vascular phase is(2 0 .7 1 ± 1 .1 2 )s .