非小细胞肺癌双源CT灌注成像与区域淋巴结转移的相关性研究

发布时间：2018-06-22 23:13

本文选题：非小细胞肺癌 + CT灌注成像　；参考：《遵义医学院》2017年硕士论文

【摘要】：目的:研究非小细胞肺癌(NSCLC)双源CT灌注参数与区域淋巴结转移的相关性,探讨双源CT灌注成像诊断NSCLC区域淋巴结转移的价值。方法:收集遵义医学院附属医院2015年1月至2016年9月经胸部CT平扫发现肺部结节或肿块并成功行双源CT灌注扫描,后经病理证实为非小细胞肺癌的患者42例,其中男性患者28例,女性患者14例,年龄25~74岁,平均53.64岁。将灌注图像传输至工作站(Siemens Syngo Multimodality workplace),选择VPCT body软件进行图像后处理分析,获得时间-密度曲线(T-DC)及血流量(BF)、血容量(BV)、通透性(PMB)、平均通过时间(MTT)等灌注参数和相应灌注伪彩图。采用PV-9000二步法免疫组化检测系统对42例NSCLC组织标本染色,然后对微血管密度(MVD)及有腔血管数目(LVN)、有腔血管面积(LVA)、有腔血管周长(LVP)进行计数。根据病理结果将42例NSCLC分为有淋巴结转移组(20例)和无淋巴结转移组(22例)。观察NSCLC有淋巴结转移组与无淋巴结转移组之间双源CT灌注参数、MVD及有腔血管参数的差异;分析NSCLC双源CT灌注参数与MVD及有腔血管参数的相关性;利用ROC曲线分析双源CT灌注参数评价NSCLC区域淋巴结转移的诊断效能。结果:NSCLC有淋巴结转移组的BF及LVA均高于无淋巴结转移组,MTT及PMB低于无淋巴结转移组,差异均有统计学意义。BV、LVN、LVP及MVD差异无统计学意义。BF与LVA及LVP均呈正相关,BV、MTT及PMB与LVN、LVA、LVP均无相关性。NSCLC双源CT各灌注参数与MVD均无相关性。根据ROC曲线分析,BF对诊断NSCLC区域淋巴结转移具有较高的价值,当以BF87.23 ml/100ml/min作为提示区域淋巴结转移的可能性时,其诊断符合率为71.4%。结论:BF及LVA与NSCLC发生区域淋巴结转移存在密切关系;双源CT灌注参数BF可作为术前预测NSCLC区域淋巴结转移的参考指标。
[Abstract]:Objective: to study the correlation between CT perfusion parameters and regional lymph node metastasis in non-small cell lung cancer (NSCLC), and to evaluate the value of dual-source CT perfusion imaging in the diagnosis of regional lymph node metastasis in NSCLC. Methods: from January 2015 to September 2016, 42 patients with non-small cell lung cancer (NSCLC) confirmed by pathology were collected from the affiliated Hospital of Zunyi Medical College. Among them, 28 cases were male and 14 cases were female, the average age was 53.64 years old (25 ~ 74 years). The perfusion images were transferred to the workstation (Siemens Syngo multimodality workplace),) for post-processing analysis with VPCT body software. The perfusion parameters such as time-density curve (T-DC), blood flow (BF), blood volume (BV), permeability (PMB), mean transit time (MTT), and the corresponding perfusion pseudo-color images were obtained. The microvessel density (MVD), the number of luminal vessels (LVN), the area of luminal vessels (LVA) and the circumference of luminal vessels (LVP) were counted in 42 cases of NSCLC by using PV-9000 two-step immunohistochemical method. The microvessel density (MVD), the number of luminal vessels (LVN), the area of luminal vessels (LVA) and the circumference of cavities (LVP) were counted. According to the pathological results, 42 cases of NSCLC were divided into lymph node metastasis group (20 cases) and no lymph node metastasis group (22 cases). To observe the difference of MVD and luminal vascular parameters between NSCLC with lymph node metastasis group and without lymph node metastasis group, analyze the correlation between MVD and luminal vascular parameters of NSCLC double source CT perfusion parameters. Dual CT perfusion parameters were used to evaluate the diagnostic efficacy of regional lymph node metastasis in NSCLC. Results the BF and LVA of the patients with lymph node metastasis were higher than those of the patients without lymph node metastasis, and the MTT and PMB levels of the patients with lymph node metastasis were lower than those of the patients without lymph node metastasis. There was no significant difference in LVP and MVD. BF was positively correlated with LVA and LVP, and there was no correlation between PMB and LVNV LVP. No correlation was found between the perfusion parameters of NSCLC and MVD. According to the analysis of ROC curve, BF has a high value in diagnosing regional lymph node metastasis of NSCLC. When BF87.23 ml/100ml/min is used as the indication of the possibility of regional lymph node metastasis, the diagnostic coincidence rate is 71.4%. Conclusion there is a close relationship between the ratio of 1: BF and LVA and the regional lymph node metastasis in NSCLC, and the double source CT perfusion parameter BF can be used as a reference index to predict the regional lymph node metastasis of NSCLC before operation.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2;R730.44

【相似文献】