多层螺旋CT灌注技术在甲状腺病变的应用研究

目的:探讨多层螺旋CT体部肿瘤灌注技术在甲状腺病变中的诊断价值。方法:采用Siemens Somatom Sensation 40型多层螺旋CT的电影模式(1s/周),0.6mm层厚,40层,120kV,60Ma,采用高压注射器注射非离子型对比剂50ml(300mgI/ml),流率3.0ml/s,延迟8s,数据采集55s,在siemens-mmwp Perfusion 2软件包分别测量16例甲状腺癌,35例良性病变(甲状腺瘤15例,结节性甲状腺肿20例)的血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)的平均值,并进行统计分析。结果:多层螺旋CT比较容易获得灌注图像,可以清晰直观的显示出肿瘤大小和轮廓,并可定量检测肿瘤内部的组织灌注状态。甲状腺癌组的BF、BV、MTT、PS的平均值分别为(324.81±218.96)ml/(100g.min)、(7.69±5.03)ml/100g、(3.87±2.52)s、(51.27±21.88)ml/(100g.min);良性病变组的BF、BV、MTT和PS的平均值分别为(311.42±238.01)ml/(100g.min)、(7.19±4.86)ml/100g、(3.99±2.77)s、(40.24±23.49)ml/(100g.min)。两组间比较,PS值差异统计学上具有显著性(P<0.05),BF、BV、MTT值差异统计学上则差异无显著性(P>0.05)。以PS≥50ml/(100g.min)作为恶性病变阈值,灵敏度为72.1%,特异度为60.8%,准确度为69.1%,阳性预测值为81.2%,阴性预测值为51.0%。结论:甲状腺良、恶性病变的PS值有显著性差异,MSCT灌注成像方法对其判断有一定诊断价值。

Study on the Application Technique of Multi-slice Spiral CT Perfusion in of Thyroid Diseases

Objective To investigate the technique of Multi-slice Spiral CT perfusign with body tumor software package and evaluate the diagnosis value of its application of thyroid disease. Methods The multi-slice dynamic CT perfusion series was performed for thyroid perfusion with cine mode （ 1 s per rotation） onamulti-slice CT scanner （ Siemens Somatom Sensation 40） ,40×0.6mm collination, 120kV,60 mA Contrast injection was done by using 50 mlnonionic contrast agent （300 mgI/ ml） ,at a flow rate of 3 ml/s with a power injector and 8 seconds delay,and data acquisition lasted for 55 seconds. The parameters of CT perfusion such as blood flow （BF）, mean transit time （MTr）, and permeability surface （PS）were measured and statistically analyzed in patients with thyroid carcinoma（ n = 16）, and benign thyroid disease（ n = 35 ） including thyroid adenoma in 15 cases and nldule goiter in 20 cases proven by pathology, respectively, on a siemens-mmwp workstation using Perfusion 2 software package （siemens）with deconvolution method. Results The images of perfusion with multi-slice CT could be readily obtained. Perfusion images can cleraly and directly display tumor diameter and outlines and quantitatively monitor blood perfusion status of tumor inner structures. The mean BF,BV,MTT and PS. The mean BF,BV,MTT, and PS in thyroid carcinoma were （324.81 ±218.96） ml/（ 100 g · min） ,（7.69 ±5.03） ml/100 g,（3.87 ±2.52）s,（51.27 ±21.88） ml/（ 100 g· min）, respectively . The mean BF, BV, MTT, and PS in benign group were （ 311.42 ± 238. 01 ） ml/（ 100 g ·min）, （ 7.19 ± 4.86 ） ml/100 g, （ 3.99 ± 2.77 ） s, （ 40.24± 23.49 ） ml/（ 100 g · min） , respectively. The mean PS between two groups had significant difference（ P 〈0.05 ）. However,the mean BF.BV and MTT were not statistically significant （P 〉0.05 ）. When PS≥50 ml/（ 100 g·min） was set as a diagnostic thershold, the sensitivity, specificity ,accuracy ,positive predictive value and negative