CT灌注成像鉴别颈部淋巴结反应性增生、淋巴结结核与淋巴结转移癌

目的评价CT灌注成像在鉴别颈部淋巴结反应性增生、淋巴结结核与淋巴结转移癌中的价值。方法对51例颈淋巴结病变行CT灌注检查,淋巴结反应性增生8例,结核13例,转移癌30例,分析病变时间-密度曲线(TDC)和灌注参数。结果淋巴结转移癌与淋巴结结核、淋巴结反应性增生的TDC曲线形态不同。淋巴结转移癌的血流量(BF)和血容量(BV)值显著高于淋巴结结核、淋巴结反应性增生,且淋巴结反应性增生BF和BV值显著高于淋巴结结核,差异有统计学意义(P<0.05)。三者的平均通过时间(MTT)和表面通透性(PS)之间差异无统计学意义(P>0.05)。结论 TDC曲线及CT灌注参数BF、BV在鉴别颈部淋巴结反应性增生、淋巴结结核与淋巴结转移癌中有价值。

CT perfusion in differential diagnosis of cervical lymph node reactive hyperplasia, tuberculosis and metastatic carcinoma

Objective To explore the value of CT perfusion(CTP) in differentiating cervical lymph nodes(CLN)reactive hyperplasia,tuberculosis and metastatic carcinoma.Methods CTP was performed in 51 patients with CLN lesions,including reactive hyperplasia 8 cases,tuberculosis 13 cases and metastasis 30cases.The data of time-density curve(TDC)and perfusion parameters were analyzed.Results The shapes and features of time-density curve(TDC) of these three type lesions were different.The average of blood flow(BF) and blood volume(BV) of lymph nodes metastases were significantly higher than those of lymph nodes tuberculosis and reactive hyperplasia.The average of blood flow(BF) and blood volume(BV) of lymph nodes reactive hyperplasia were significantly higher those of lymph nodes tuberculosis(P<0.05).The average of mean transit time(MTT) and permeability surface(PS) among three type CLN were not significantly different(P>0.05).Conclusion TDC and CT perfusion parameters BF and BV were useful in differentiating cervical lymph nodes CLN)reactive hyperplasia,tuberculosis and metastatic carcinoma.