双源螺旋CT灌注孤立性肺结节的诊断技术及临床价值分析

目的研究比较双源螺旋CT灌注成像对于孤立性肺结节（SPN）良恶性的诊断价值及临床应用。方法对于我院2011年11月至2013年12月50例未经治疗的直径≤3.0cm的肺孤立结节根据病理结果分为恶性结节组和良性结节组,分别进行双源螺旋CT灌注成像,计算结节的血流量（BF）、血容量（BV）、平均通过时间（MTT）和通透性值（Permeability,PMB）。同时绘制同层面结节的时间-密度曲线（TAC）,判断结节良恶性,和手术病理结果进行对比分析,计算各灌注参数对于孤立性肺结节良恶性诊断的准确率、敏感性和特异性。结果经CT引导下肺穿刺活检或手术病理证实,发现恶性结节34例,良性结节16例。两组结节的各灌注参数差异显著,P〈0.01;同层面结节的TAC曲线良恶性差异显著,有助于提示结节性质,血容量（BV）、平均通过时间（MTT）、血流量（BF）和通透性值（PMB）对于孤立性肺结节良恶性诊断的准确率、敏感性和特异性分别为88%,88.24%,87.50%;90%,94.12%,81.25%;94.00%,91.12%,100.00%;86.00%,94.12%,68.75%。结论双源螺旋CT灌注成像技术有助于早期诊断孤立性肺结节性质,为进一步治疗方案提供思路。

The Analysis on Diagnosis Technology and Clinical Value of Perfusion Solitary Pulmonary Nodules of Dual Source Spiral CT

Objective research and compare the diagnosis value and clinical application of optimum and malignant influence of dual source spiral CT perfusion imaging on solitary pulmonary nodules （SPN）. Methods According to the pathological results, the 50 cases of untreated solitary pulmonary nodules with Diameter of≤3.0cm from November 2011 to December 2013 can be divided into malignant nodules group and benign nodules group, and conduct dual source spiral CT perfusion imaging on each group, calculate the blood flow （BF）, blood volume （BV）, mean transit time （MTT） and permeability （PMB） of nodules. At the same time, draw the time-density curve in the same level node （TAC） to judge the optimum and malignant influence of nodules and the operation pathology results to conduct compare and analysis, calculate the accuracy, sensitivity and specificity of each perfusion parameters on the malignant and benign diagnosis of solitary pulmonary nodules. Results through the confirmed by lung biopsy or operation pathologically and guided by CT, 34 cases of malignant nodules and 16 cases of benign nodules are found. Each of the perfusion parameters of the two groups of nodules have significant difference, P〈0.01;the benign and malignant TAC curve in the same level nodules have significant difference, which is help to indicate the accuracy, sensitivity and specificity of diagnosis of nodules nature, blood volume （BV）, mean transit time （MTT）, blood flow （BF） and permeability （PMB） on benign and malignant solitary pulmonary nodules is 88%, 88.24%, 87.50%;90%, 94.12%, 81.25%; 94.00%, 91.12%, 100.00%; 86.00%, 94.12%, 68.75%. Conclusion dual source spiral CT perfusion imaging technology is good for the early diagnosis on solitary pulmonary nodules nature and provides ideas for the further treatment plan.