肺结节或肿块320排动态容积CT双入口灌注成像与病理的对照

发布时间：2018-11-20 11:25

【摘要】：目的:探讨肺结节或肿块性病变320排动态容积CT双入口灌注成像与病理基础的关系,研究肺内不同组织学类型病变灌注特点与血流动力学规律。方法:搜集本院2016年8月-2017年2月的50例经手术切除(41例)、穿刺活检(9例)病理组织学证实的肺内结节或肿块性病变患者,包括肺腺癌12例,肺鳞癌8例,小细胞肺癌6例,急性炎症9例,慢性炎症7例,肺结核8例。所有患者行320排动态容积CT灌注扫描,得到相关的灌注参数结果与病理结果进行对照分析。结果:肺内良性与恶性结节或肿块的支气管动脉血流量(BAF)、灌注指数(PI)差异均具有统计学意义(P0.05)。肺内良性与恶性结节或肿块的肺动脉血流量(PAF)值差异无统计学意义(P0.05)。PI鉴别良恶性肿瘤的最佳阈值为57.65,敏感度为90.0%,特异度为66.7%,阳性预测值87.5%,阴性预测值85.5%。肺结节或肿块的灌注结果与其病理类型有关。结论:肺结节或肿块的灌注结果与病理类型具有密切的关系,恶性病变以支气管动脉供血为主,良性病变以肺动脉供血为主。320排动态容积CT肺双入口灌注扫描成像技术在鉴别肺部病变的良恶性中具有重要的作用。
[Abstract]:Objective: to investigate the relationship between perfusion imaging and pathological basis of 320 row dynamic volume CT perfusion imaging in pulmonary nodule or mass lesions, and to study the perfusion characteristics and hemodynamics of lung lesions of different histological types. Methods: from August 2016 to February 2017, 50 patients with intrapulmonary nodule or mass lesions, including 12 adenocarcinoma and 8 squamous cell carcinoma of the lung, were examined by biopsy and biopsy, including 12 cases of lung adenocarcinoma and 8 cases of squamous cell carcinoma of the lung, which were confirmed by surgical resection (41 cases) and biopsy (9 cases), including lung adenocarcinoma (12 cases) and squamous cell carcinoma (8 cases). There were 6 cases of small cell lung cancer, 9 cases of acute inflammation, 7 cases of chronic inflammation and 8 cases of pulmonary tuberculosis. All patients underwent 320 row dynamic volume CT perfusion scan, and the results of perfusion parameters were compared with pathological results. Results: there were significant differences in (BAF), perfusion index (PI) between benign and malignant pulmonary nodules or masses (P0.05). There was no significant difference in (PAF) value of pulmonary artery blood flow between benign and malignant nodules or masses (P0.05). The optimal threshold value of). PI for differentiating benign and malignant tumors was 57.65, the sensitivity was 90.0 and the specificity was 66.7%. The positive predictive value was 87.5 and the negative predictive value was 85.5. The perfusion results of pulmonary nodules or masses were related to their pathological types. Conclusion: the perfusion results of pulmonary nodules or masses are closely related to the pathological types. The main malignant lesions are bronchial artery blood supply. Pulmonary artery blood supply is the main benign lesion. 320 row dynamic volume CT pulmonary perfusion imaging plays an important role in differentiating benign and malignant pulmonary lesions.
【作者单位】：广东医科大学附属医院放射科;
【基金】：湛江市非资助科技攻关计划项目(2015B01071)
【分类号】：R563;R816.41

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