双源CT容积灌注成像技术在诊断孤立性肺结节中的应用价值

目的：探讨双源CT容积灌注成像技术在诊断孤立性肺结节（SPN）中的应用价值。方法选取2011年3月~2013年12月我院经病理确诊的116例SPN患者，均行双源CT容积灌注成像扫描，观察CT图像特征，并分析血容量（BV）、血流量（BF）、表面通透性（PS）、对比剂平均通过时间（MTT）等，计算可测层面的SPN平均灌注值。根据病理诊断结果进行SPN的良、恶性分组。结果恶性结节的BV、BF和PS值分别为（4.63±1.52）mL/100g、（98.36±48.25）mL/（100g·min）和（17.23±7.65）mL/（100g·min），均显著高于良性结节病例值（2.28±1.76）mL/100g、（46.33±30.23）mL/（100g·min）和（7.42±7.28）mL/（100g·min），差异具有统计学意义（P＜0.05）；恶性结节和良性结节的MTT值分别为（5.13±2.52）s、（6.16±4.88）s，差异无统计学意义（P＞0.05）。单独利用BV、BF或PS诊断SPN良、恶性的敏感性分别为95%、91%、86%；单独利用BV、BF或PS诊断SPN良、恶性的特异性分别68%、64%、77%。BV＋PS及BF＋PS联合诊断SPN良、恶性的特异性均为82%，较应用单个指标的特异性增高。结论采用双源CT容积灌注技术诊断和鉴别SPN可提高检出率，可为早期确诊提供证据。

Application Value of Dual-Source CT Volume Perfusion Imaging in the Diagnosis of Solitary Pulmonary Nodules

Objective To explore the application value of Dual-source CT volume perfusion imaging in the diagnosis of solitary pulmonary nodules （SPNs）. Methods 116 cases of SPNs confirmed by pathological diagnosis in our hospital from March 2011 to December 2013 were chosen. All the patients were examined by Dual-source CT perfusion scans, and then we observed the characteristics of CT imaging and analyzed the blood volume （BV）, blood lfow （BF）, permeability surface （PS）, mean transit time （MTT） to calculate average perfusion values of SPNs’ measurable layer. Benign and malignant groups were divided according to the results of pathological diagnosis. Results The values of BV, BF and PS in malignant group were （4.63±1.52） mL/100g, （98.36±48.25） mL/（100g·min） and （17.23±7.65） mL/（100g·min） respectively, and these values were obviously higher than those of benign group, whose values were （2.28±1.76） mL/100g, （46.33±30.23） mL/（100g·min） and （7.42±7.28） mL/（100g·min）, respectively. There were signiifcant differences in BV, BF and PS values between malignant group and benign group （P〈0.05）. The values of MTT in benign group and malignant group were （5.13±2.52） s and （6.16±4.88） s, respectively, and the differences in MTT values between two groups were not signiifcant （P〉0.05）. In diagnosing benign and malignant SPNs, the diagnosis sensitivities based solely on BV, BF or PS were 95%, 91%and 86%, respectively and the specificities were 68%, 64%and 77%, respectively. The diagnosis sensitivities of BV＋PS and BF＋PS were both 82%, which is higher than that of using a single indicator. Conclusion The application of Dual-source CT volume perfusion technology can improve the detection rate of SPNs and provide evidences for early conifrmation of SPN.