伍建林,李光军,王克礼,李智勇,刘晓峰.多层螺旋CT灌注成像鉴别诊断肺癌与肺良性肿物[J].中国医学影像技术,2005,21(4):551~555
多层螺旋CT灌注成像鉴别诊断肺癌与肺良性肿物
Perfusion imaging with multi-slice spiral CT in the differential diagnosis of lung cancer and pulmonary benign masses
投稿时间:2005-01-25  修订日期:2005-02-01
DOI:
中文关键词:  肺癌  灌注  体层摄影术,X线计算机
英文关键词:Lung neoplasms  Perfusion  Tomography, X-ray computed
基金项目:
作者单位E-mail
伍建林 大连医科大学附属第一医院放射科,辽宁 大连 116011 jianlin.wu@guerbet.com.cn 
李光军 大连医科大学附属第一医院放射科,辽宁 大连 116011  
王克礼 大连医科大学附属第一医院放射科,辽宁 大连 116011  
李智勇 大连医科大学附属第一医院放射科,辽宁 大连 116011  
刘晓峰 大连医科大学附属第一医院放射科,辽宁 大连 116011  
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中文摘要:
      目的 探讨16层螺旋CT灌注成像在肺癌与肺良性肿物鉴别诊断中的应用价值。方法 选择34例肺肿物病变进行前瞻性CT灌注研究,其中肺癌25例(腺癌13例,鳞癌12例),肺良性肿物9例(炎性假瘤4例,结核瘤4例,错构瘤1例)。采用GE Lightspeed Qx/i plus 16 层螺旋CT,电影模式(5 mm/4层),总扫描采集时间40 s。使用随机CT灌注2-体部软件包分析和测定肺病灶的血容积(BV)、血流量(BF)、平均通过时间(MTT)和表面通透性(PS)的数值。结果 肺癌的各种灌注参数值均高于肺良性肿物,其中BV、MTT、PS值均有统计学差异(P<0.05),BV有显著性统计学差异(P<0.01)。若以BV≥5 ml/100 mg为恶性肿瘤诊断域值,灵敏度96%,特异度78%,阳性预测值92%,阴性预测值87.5%;若以PS≥25 ml/(100 mg·min)为恶性肿瘤诊断域值,灵敏度68%,特异度67%,阳性预测值85%,阴性预测值42%。结论 多层螺旋CT灌注成像技术有助于肺癌和肺良性肿物的鉴别诊断。
英文摘要:
      Objective To evaluate the differential diagnostic ability of 16-slice sprial CT perfusion imaging between lung cancer and pulmonary benign masses. Methods A total of 34 patients with pulmonary masses were studied prospectively with GE Lightspeed Qx/i plus 16-slice helical CT using cine dynamic scan (5 mm/4 slice). Lung cancer was histologically proven in 25 cases (adenocarcinoma in 13 cases, squamous carcinoma in 12 cases), and inflammatory pseudotumor was found in 4 cases, tuberculoma in 4 cases and hamartoma in 1 case. With the CT perfusion 2-body tumor software, the parameters of CT perfusion including blood volume (BV), blood flow (BF),mean transit time (MTT) and permeability surface (PS) were analyzed. Results These parameter values in lung cancer were all higher than those in pulmonary benign masses. There were significant differences in BV, MTT and PS (P<0.05) between the two groups, especially in BV (P<0.01).When BV≥5 ml/100 mg was set as a diagnostic threshold, the sensitivity, specificity, positive predict values and negative predict values was 96%, 78%, 92%, and 87.5%, respectively. When PS≥25 ml/(100 mg·min) was set as a diagnostic threshold, the sensitivity, specificity, positive predict values and negative predict values was 68%, 67%, 85%, and 42%, respectively. Conclusion It is helpful to differentiate lung cancer from pulmonary benign masses with MSCT perfusion imaging.
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