320排动态容积CT对正常人肺实质不同区域灌注定量研究

发布时间：2018-06-06 17:43

本文选题：排CT + 肺灌注　；参考：《临床放射学杂志》2016年10期

【摘要】：目的从定量角度初步探讨正常人肺实质肺循环及体循环的血流构成比情况,并比较正常不同区域灌注参数的差异,进一步探讨320排低剂量CT肺灌注技术的可行性和优越性。方法搜集胸片发现"可疑肺结节"、怀疑肿瘤肺转移或者食管癌患者需行胸部CT增强扫描者,最终将20例正常资料纳入研究。采用320排CT(Aquilion One,日本东芝医疗器械公司)进行肺容积扫描,扫描参数:电压80 k V,电流70 m A,采用自适应迭代剂量降低方法进行图像重建,后处理用最大斜率法数学模型,对容积数据用图像后处理软件进行分析,生成4条时间-密度曲线,并记录各个曲线达峰时间;分析得到肺实质伪彩色血流灌注图像,分别显示肺动脉血流量(PAF)、支气管动脉血流量(BAF)及灌注指数[PI,PI=PAF/(PAF+BAF)];然后分别从重力方向(腹侧、中间、背侧)和非重力方向(上部、中间、下部)评价,各个区域均选择连续3个层面的图像进行测值,分别获得每个区域的平均灌注参数(PAF、BAF、PI值)。用单因素方差分析正常组肺实质重力与非重力方向各个区域肺灌注的差异。结果本研究每位受检者总的辐射剂量为4.02 m Sv。正常肺实质组灌注参数PAF在重力方向腹侧、中间、背侧分别为(123.2±32.9)ml·min~(-1)·100ml~(-1)、(137.1±33.6)ml·min~(-1)·100ml~(-1)、(158.5±38.7)ml·min~(-1)·100ml~(-1);PAF在重力方向差异有统计学意义(F=13.29,P0.001),但BAF、PI差异无统计学意义。非重力方向上部、中间、下部PAF、BAF、PI差异均存在统计学意义(P0.05),但两两比较,各个参数仅下部与上部差异有统计学意义(P0.05)。结论 320排低剂量CT灌注成像技术能从定量角度评估肺实质肺循环和体循环血流构成比情况。正常肺实质主要由肺循环肺动脉供血,大约为98.76%,体循环支气管动脉供血所占比例较小,PAF、BAF均受重力及血流分布影响。
[Abstract]:Objective to investigate the blood flow composition ratio of pulmonary parenchyma and systemic circulation in normal subjects from the quantitative point of view, and to compare the perfusion parameters in different regions of normal subjects, and to further explore the feasibility and superiority of 320 row low dose CT perfusion technique. Methods chest X-ray findings of "suspicious pulmonary nodules", suspected lung metastasis or esophageal cancer patients need chest CT enhanced scanning, and 20 cases of normal data were included in the study. The lung volume scanning was carried out with 320 row CTX Aquilion (Toshiba Medical Devices Company, Japan). The scanning parameters were as follows: voltage 80 kV, current 70 Ma, adaptive iterative dose reduction method was used to reconstruct the image, and the maximum slope mathematical model was used for post processing. The volume data were analyzed by image post-processing software to generate 4 time-density curves and record the peak time of each curve. The pseudo-color perfusion images of pulmonary parenchyma were obtained. Pulmonary artery blood flow (PAF), bronchoarterial blood flow (BAFs) and perfusion index (PII-PIPAF / PAF / PAF BAFs) were shown respectively, and then evaluated from gravity (ventral, middle, dorsal) and non-gravity (upper, middle, lower) direction, respectively. The mean perfusion parameters of each region were measured by three consecutive images and the BAFPI-value of each area was obtained. Univariate ANOVA was used to analyze the lung perfusion in different regions of lung parenchyma gravity and non-gravity in normal group. Results the total radiation dose of each patient was 4.02 MV. In the normal pulmonary parenchyma group, the perfusion parameters were 123.2 卤32.9)ml min-1 in the gravity direction, 123.2 卤32.9)ml min-1 in the middle side, and 137.1 卤33.6)ml min-1 in the dorsal side, respectively. There was no significant difference in the gravity direction between the normal pulmonary parenchyma group and the normal pulmonary parenchyma group, but there was no significant difference in the gravity direction of the normal pulmonary parenchyma group (P < 0.05). In the non-gravity direction, there were significant differences in Pi between the upper, middle and lower parts of PAFU, but the difference of each parameter was significant only in the lower part and the upper part. Conclusion 320-slice low-dose CT perfusion imaging can quantitatively evaluate pulmonary parenchyma pulmonary circulation and systemic circulation. The normal pulmonary parenchyma is mainly supplied by the pulmonary artery of the pulmonary circulation, which is about 98.76. The proportion of the blood supply of the systemic circulation bronchial artery is smaller and the BAF of PAF is affected by gravity and blood flow distribution.
【作者单位】：暨南大学附属第一医院医学影像中心;中山大学孙逸仙纪念医院放射科;
【分类号】：R816.4

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