丁毅,张镭,钱晓军,翟仁友.64层螺旋CT灌注成像在孤立性肺结节鉴别诊断中的应用[J].中国医学影像技术,2007,23(2):214~218
64层螺旋CT灌注成像在孤立性肺结节鉴别诊断中的应用
Perfusion imaging with 64-slice spiral CT in differential diagnosis of solitary pulmonary nodule
投稿时间:2006-10-09  修订日期:2006-11-13
DOI:
中文关键词:  孤立性肺结节  灌注  体层摄影术,X线计算机
英文关键词:Solitary pulmonary nodule  Perfusion  Tomography, X-ray computed
基金项目:
作者单位E-mail
丁毅 首都医科大学附属北京朝阳医院放射科,北京 100020  
张镭 首都医科大学附属北京朝阳医院放射科,北京 100020  
钱晓军 首都医科大学附属北京朝阳医院放射科,北京 100020  
翟仁友 首都医科大学附属北京朝阳医院放射科,北京 100020 zhairenyou@vip.163.com 
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中文摘要:
      目的 探讨64层螺旋CT灌注成像在孤立性肺结节的良恶性鉴别诊断中的应用价值。方法 对32例孤立性肺结节患者(病灶直径≤4 cm)进行灌注扫描,测定肺内病灶的血容积(BV)、血流量(BF)、平均通过时间(MTT)、表面通透性(PS)的数值和时间-密度曲线(TDC)。并可在时间-密度曲线基础上,测量孤立性肺结节增强前的CT值、强化值、结节-动脉强化值比。结果 肺恶性结节的灌注参数、强化值和结节-动脉强化值比均高于肺良性结节,有显著性差异(P值均<0.05)。炎性结节的强化值及结节-动脉强化值比(S/A)与恶性结节无显著性差异(P>0.05)。恶性结节、炎性结节、良性结节的TDC形态不同。结论 结节动态对比增强CT提供了孤立性肺结节的血流模式的定量信息,并可用于无创性的诊断和评价孤立性肺结节。
英文摘要:
      Objective To evaluate the differential diagnostic ability of 64-slice spiral CT perfusion imaging between benign and malignant solitary pulmonary nodules(SPN). Methods A total of 32 patients with solitary pulmonary nodules (the lesion's diameter≤4 cm) underwent perfusion scan with 64-slice spiral CT (LightSpeed VCT; GE Medical Systems) scanner. The parameters of CT perfusion including blood volume (BV), blood flow (BF), mean transit time (MTT), permeability surface (PS) and time-density curve (TDC) were analyzed. The peak height in density, enhancement value (=peak height density subtract per-contrast density) and SPN-to-aorta enhanced ratio were measured. Results These parameter values in pulmonary malignancy nodules were all highter than those in pulmonary benign nodules. The enhancement value and SPN-to-aorta enhanced ratio of the malignant was significantly higher than that of benign nodules (P=0.000, P=0.001). No statistically significant differences in the enhancement value and SPN-to-aorta enhanced ratio were found between malignant and inflammatory nodules. The TDC appeared different for malignant, inflammatory and benign nodules. Conclusion Dynamic contrast enhanced functional CT can provide quantitative information about blood flow patterns of SPNs and proved to be an alternate non-invasive option in the evaluation and management of SPN.
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