320排CT双入口灌注参数预测肺癌纵隔淋巴结转移的应用价值

发布时间：2018-09-11 11:09

【摘要】：目的:探讨肺癌原发灶的双入口技术灌注成像参数与纵隔淋巴结转移的关系及其诊断效能。方法:对61例经术后病理证实的肺癌患者行320排CT灌注成像(CTPI)检查,运用双入口(dual-input,DI)模式对图像进行后处理,采用两独立样本t检验分析纵隔淋巴结转移与肺癌原发灶的DI-CTPI参数的关系,并运用ROC曲线分析DI-CTP参数对肺癌合纵隔淋巴结转移的诊断效能。结果:有淋巴结转移组(27例)支气管动脉血流量(BAF)高于无淋巴结转移组(34例),差异有统计学意义(t=4.173,P0.001);有淋巴结转移组的灌注指数(PI)低于无淋巴结转移组,差异有统计学意义(t=-3.378,P=0.001);两组肺动脉血流量(PAF)间的差异无统计学意义(P0.05)。三个参数中,BAF的ROC曲线下面积(AUC)最大(0.773),以BAF56.42mL/(min·100mL)作为预测肺癌纵隔淋巴结转移的临界值时,敏感度为74.1%,特异度为76.5%;PI的AUC为0.739,以PI41.57%作为预测纵隔淋巴结转移的临界值时,敏感度为82.4%,特异度为66.7%。结论:肺癌DI-CTPI参数对术前预测肺癌是否发生纵隔淋巴结转移有重要参考价值,从而可为肺癌的术前分期及治疗方案的制定等提供参考。
[Abstract]:Objective: to investigate the relationship between perfusion imaging parameters and mediastinal lymph node metastasis in primary lung cancer. Methods: Sixty-one patients with lung cancer confirmed by postoperative pathology were examined by (CTPI) with 320 rows of CT perfusion imaging, and the images were processed by double entrances (dual-input,DI) mode. The relationship between mediastinal lymph node metastasis and DI-CTPI parameters of primary lung cancer was analyzed by two independent t-test. The diagnostic efficacy of DI-CTP parameters for lung cancer combined with mediastinal lymph node metastasis was analyzed by ROC curve. Results: the bronchial arterial blood flow (BAF) in patients with lymph node metastasis (27 cases) was significantly higher than that in patients without lymph node metastasis (34 cases), the (PI) of lymph node metastasis group was lower than that of non-lymph node metastasis group (P 0.001). There was significant difference between two groups in pulmonary artery blood flow (PAF) (P 0.05), but there was no significant difference between the two groups in pulmonary artery blood flow (PAF) (P0.05). Of the three parameters, the area under the ROC curve was the largest (0.773). When BAF56.42mL/ (min 100mL) was used as the critical value for predicting mediastinal lymph node metastasis of lung cancer, the sensitivity was 74.1 and the AUC with a specificity of 76.5p was 0.739. When PI41.57% was used as the critical value for predicting mediastinal lymph node metastasis, PI41.57% was used as the critical value for predicting mediastinal lymph node metastasis. The sensitivity was 82.4 and the specificity was 66.7. Conclusion: the DI-CTPI parameters of lung cancer have important reference value in predicting the mediastinal lymph node metastasis of lung cancer before operation, which can provide reference for preoperative staging of lung cancer and the formulation of treatment plan.
【作者单位】：郑州大学第一附属医院放射科;
【分类号】：R730.44;R734.2

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