肺癌CT灌注成像与微血管管腔化程度的相关性

目的：探讨肺癌CT灌注成像与微血管管腔化程度的关系。方法：对36例肺癌结节进行CT灌注成像，记录灌注参数，包括血流量（BF）、血容量（BV）和最高增强值（PEI），将各值分别与肺癌的微血管密度（MVD）、未形成完整管腔的MVD以及分化程度做相关性分析；将36例肺癌按灌注参数高低分为高灌注组与低灌注组，分析2组微血管管腔化程度和分化程度的差异。结果：36例肺癌结节灌注参数BF,BV和PEI的值分别为(39.7±11.5)mL/(100 mg·min)，(8.6±3.8)mL/100 g 和(20.1±8.6)HU。PEI与MVD呈正相关（r=0.645，P＜0.01），BF与MVD呈负相关（r=-0.280，P=0.048）；BF,BV,PEI与未形成完整管腔的MVD均呈负相关（均P＜0.05），其中BF与未形成完整管腔的MVD相关性最高（r=-0.882，P＜0.01）。高灌注组中未形成完整管腔的MVD低于低灌注组，2组MVD无明显差别。BF，BV，PEI与分化程度均呈负相关，其中BF与分化程度的相关性最高（r=-0.751，P＜0.01）。结论：CT灌注成像有助于判定肺癌分化程度与血管生成状态，其病理基础主要与病变微血管管腔化程度有关。

Correlation between multi-slice spiral CT pulmonary perfusion imaging and cavity of microvessle in lung cancer

ObjectiveTo investigate the relation between multi-slice spiral CT pulmonary perfusion imaging and the cavity of microvessle in lung cancer. MethodsAltogether 36 patients with malignant nodules who underwent multi-slice spiral CT perfusion scan were examined.The perfusion parameters were collected and compared with the microvessle density (MVD), the uncomplete lumen MVD, and the differentiation of non-small cell lung cancer (NSCLC). The patients were divided into a hyper-perfusion group and a hypo-perfusion group by the value of perfusion parameters. The maturity of microvessle and the degree of differentiation in NSCLC between the 2 groups was analyzed. ResultsBlood flow (BF), blood volume (BV), and peak enhancement image(PEI) of the malignant nodules were (39.7±11.5) mL/(100 mg·min)， (8.6±3.8)mL/100 g, and (20.1±8.6)HU, respectively. There was a positive correlation between PEI and MVD（r=0.645，P＜0.01）, and a negative correlation between BF and MVD（r=-0.280，P=0.048）. There were negative correlations of BF, BV, PEI with the uncomplete lumen MVD (P＜0.05). BF had the highest correlation coefficient（r=-0.882，P＜0.01）.The uncomplete lumen MVD of the hyper-perfusion group was significantly lower than that of hypo-perfusion group (P＜0.05),but there was no significant difference in MVD between the 2 groups. There were negative correlations of BF, BV,PEI with the degree of differentiation (P＜0.05). BF had the highest correlation coefficient（r=-0.751，P<0.01）.ConclusionMulti-slice spiral CT pulmonary perfusion imaging is helpful to evaluate the degree of differentiation and status of angiogenesis in lung cancer, and its basis is the cavity of microvessle.