64排螺旋CT血流灌注对肺内肿块的诊断价值

目的:探讨肺部肿块的CT血流灌注的特征及临床价值.方法:对35例患者(男21例,女14例;平均年龄,64.7岁,年龄范围,24～83岁)进行CT灌注检查.使用64排螺旋CT,先平扫有问题的结构区域,然后选定肿块扫描层面,使用高压注射器,经肘静脉注入50mL·300mg·100mL-1的优维显,速率为4mL·s-1,延迟5 s后,以电影模式行多层灌注扫描,持续35～40 s.使用Perfusion 3灌注软件测量血容量及表面透过性乘积.3个独立样本(肺癌组、结核组及炎症组)两两进行统计学分析(t检验).结果:恶性肿块20例(4例鳞癌,12例腺癌,1例未分化癌,3例转移癌),炎性肿块8例,结核灶7例.肺癌、结核灶及炎性肿块的灌注均值(BV和PS)分别为:(8.43±2.44)mL·100g-1,(24.30±5.80)mL·min-1·100g-1;(1.90±0.60)mL·min-1·100g-1,(1.19±0.37)mL·min-1·100g-1;(19.73±6.65)mL·100g-1,(30.01±9.06)mL·min-1·100g-1.肺癌组与结核灶组及炎性肿块组与结核灶组之间的灌注均值均有显著差异(p<0.05);肺癌组与炎性肿块组之间的BV均值有显著差异(p=0.014,t=2.639),但二者PS均值无统计学意义(p=0.506,t=0.674).结论:利用灌注值可以区分肺癌与结核灶、炎性肿块与结核灶,虽然单独依靠灌注值很难区分肺癌与炎性肿块,但是血流灌注仍间接反映了肺部肿块的生物学行为.

The Clinical Value of 64-row Spiral CT Perfusion for Diagnosis of Pulmonary Masses

Objective:To explore the characteristics of the CT Hemoperfusion for lung masses and its clinical value.Methods:35 consecutive patients(21 men and 14 women;mean age,64.7 years;age range,24-83 years) underwent perfusion CT.With a spiral plus 64 scanner,an plain scan was performed through the anatomical region in question.Then sections through the masses were selected.Using an injector pump,50 mL of 300 mg/100 mL ultravist contrast agent was injected via cubital vein at a rate 4 mL/s,and 5 s delay,then a mult...