摘要
目的利用16及64层螺旋CT评价孤立性肺结节容积灌注是否均匀。方法85例孤立性肺结节（直径≤4．0cm，57例恶性结节，15例活动性炎症，13例良性结节）患者，在增强前、后采用16层（30例）及64层（55例）螺旋CT进行同层动态扫描。注入对比剂后11—41s，每秒扫描1次；90S扫描1次。16层螺旋CT扫描层厚：病灶直径3．0—4．0cm时8．0mm；2．0—3．0cm时6．0mm01．5—2．0cm时4．0mm；1．0—1．5cm时3．0mm；〈1．0cm时2．0mm（其中病灶直径3．0cm时，层厚8．0mm；2．0cm时，6．0mm；1．5cm时，4．0mm）。64层螺旋CT扫描层厚：病灶直径3．0—4．0cm时5．0mm；〈3．0cm时2．5mm。记录孤立肺结节增强前后各时相的CT值。分别计算肺结节3个中央有效层面强化值、灌注值、结节-主动脉强化值比、平均通过时间。使用均数间方差检验进行统计学分析。结果3个中央层面强化CT值分别为（30．95±14．53）、（25．10±13．32）、（32．37±15．85）HU、灌注值分别为（33．01±21．35）、（23．70±12．87）、（29．00±15．47）ml·min^-1·100g^-1，结节-主动脉强化值比分别为（13．58±6．41）％、（10．95±5．76）％、（13．64±6．20）％，平均通过时间分别为（11．61±5．74）、（11．97±3．55）、（13．44±3．74）S，差异均有统计学意义（F值分别为5．913、6．464、5．333、3．837，P值分别为0．003、0．002、0．005、0．023）。平扫的CT值差异无统计学意义（F=0．032，P=0．968）。结论孤立肺结节容积灌注是不均匀的，推荐采用CT容积灌注成像的方式对孤立肺结节血流模式进行研究。
Objective To investigate whether the perfusion of the solitary pulmonary nodules （SPNs） is homogeneous derived with 16-slice spiral CT and 64-slice spiral CT. Methods Eight-five patients with. SPNs （ diameter ≤4 cm; 57 maliagnant; 15 active inflammatory; 13 benign） underwent multilocation dynamic contrast material-enhanced serial CT. One scan was obtained every 1 seconds during 11-41 seconds without scanning interval after injection, one scan was obtained at 90 seconds. TOSHIBA AquilionMarconi 16 ： The section thickness was 8. 0 mm for lesions 3. 0-4. 0 cm, 6. 0 mm for 2.0-3.0 cm,4. 0 mm for 1.5-2 . 0 cm, 3.0 mm for 1.0-1.5 cm and 2. 0 mm for lesions 〈 1.0 cm. GE Lightspeed 64 ： The section thickness was 8. 0 mm for lesions3. 0-4. 0 cm and 2. 5 mm for 〈 3.0 cm. Precontrast and postcontrast attenuation on every scan was recorded . The peak height , perfusion, ratio of peak height of the SPNs to that of the aorta and mean transit time of three central valid sections were calculated. The significance of the difference among groups was analyzed by means of ANOVA. Results The peak heights in three sections were （ 30. 95 ± 14. 53 ）, （ 25.10 ± 13.32 ）, （ 32. 37 ± 15.85 ） HU, respectively, the perfusions （ 33.01 ± 21.35 ）, （ 23. 70 ± 12. 87 ）, （ 29.00 ± 15.47 ） ml· min ^-1 ·100 g ^-1, the ratios of peak height of the SPN to that of the aorta （13.58 ±6.41）% ,（10.95 ±5.76）% ,（13. 64 ± 6. 20） % and the mean transit times （ 11.61 ± 5.74）, （ 11.97 ± 3.55 ）, （ 13.44 ± 3.74 ） s. Statistically significant differences were found among three sections in the peak height （F = 5.913, P = 0. 003 ）, perfusion （ F = 6. 464,P = 0. 002 ）, ratio of peak height of the SPN to that of the aorta （ F = 5. 333, P = 0. 005 ） and mean transit time （ F = 3. 837, P = 0. 023 ）. No statistically significant differences were found among three sections in precontrast attenuation（ F = 0. 032,P = 0. 968 ）. Conclusion The volume perfusion of the SPNs is inhomogeneous,it is suggested to evaluate blood flow patterns of the solitary pulmonary nodules with CT volume perfusion imaging.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2008年第8期862-865,共4页
Chinese Journal of Radiology
基金
上海市重点课题资助（06DZ19503）
上海长征医院“三重三优”学科人才建设计划重大临床项目基金资助（06CZ1503）
关键词
体层摄影术
X线计算机
硬币病变
肺
图像增强
Tomography, X-ray computed
Coin lesion, pulmonary
Image enhansement
作者简介
李慎江现在解放军第八十八医院放射科，271000泰安
通信作者：肖湘生，Email：cjr．xxsh@vip．163．com
