孤立性肺结节双低CT灌注与增强成像的比较研究

发布时间：2018-06-11 12:35

  本文选题：孤立性肺结节 + 灌注成像　； 参考：《中国医学计算机成像杂志》2015年01期

【摘要】：目的:对比分析低浓度对比剂结合低剂量宝石CT灌注及增强成像在孤立性肺结节(SPN)良恶性鉴别诊断中的应用价值。方法:对46例孤立性肺结节患者行宝石CT低剂量增强加灌注扫描,其中恶性34例(A组),良性12例(B组)。比较两组结节血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)以及增强前后的结节强化值、结节-主动脉强化值比(S/A)的差异。结果:良、恶性SPN的BV值及PS值的差异均有统计学意义(P值分别为0.009和0.003),BF值及MTT值的差异无统计学意义(P值分别为0.889和0.149);以BV≥7ml/100g联合PS≥7ml/100g/min较单独以BV或PS作为诊断恶性结节的阈值时的敏感性、特异性、阳性预测值、阴性预测值和诊断符合率均增高,分别为96.6%、64.7%、82.4%、91.7%、84.8%。良、恶性SPN的结节强化值及结节-主动脉强化值比的差异有统计学意义(t值分别为0.004和0.022);以结节强化值≥15HU、结节-动脉强化值比≥10%作为恶性结节的诊断阈值,灵敏度、特异度、阳性预测值、阴性预测值依次为94.1%、91.7%、96.97%和84.6%。结论:以PS≥7ml/100g/min联合结节强化值≥15HU、结节-动脉强化值比≥10%作为恶性结节诊断阈值时,有利于SPN良、恶性的鉴别,在CT灌注及增强成像诊断恶性SPN的准确性相近时,应选择诊断敏感度较高的BV值。
[Abstract]:Objective: to compare and analyze the value of low concentration contrast medium combined with low dose gemstone CT perfusion and enhanced imaging in the differential diagnosis of benign and malignant solitary pulmonary nodules (SPNs). Methods: Forty-six patients with solitary pulmonary nodules were examined with low dose enhanced sapphire CT and perfusion scanning. 34 cases of malignant pulmonary nodules were found in group A and 12 cases in benign group B. The mean transit time (MTT), surface permeability (PSV), nodule enhancement and the ratio of nodular to aortic enhancement (S / A) were compared between the two groups in terms of nodule blood flow volume (BFV), blood volume (BV), mean transit time (MTT), surface permeability (PSV) and the ratio of nodular to aortic enhancement (S / A). Results: good, The difference of BV value and PS value of malignant SPN were statistically significant (P = 0.009, P = 0.003, P = 0.889 and P = 0.149, respectively), and that of BV 鈮，

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