320排CT双入口灌注技术在肺结核化疗疗效评价中的应用

目的：探讨运用320排CT双入口灌注成像技术，评估结核病灶灌注参数值对肺结核化疗近期效果的预测作用。方法：将30例肺结核按形态学分为结核球、空洞型病灶和浸润型病灶三组。化疗前7 d内CT检查与化疗后30 d的CT平扫结果进行比较，根据标准评定疗效分成缓解组与未缓解组。化疗前7 d内及化疗后14 d行2次CT灌注扫描，比较化疗前、化疗后早期CT灌注参数的变化与化疗疗效的关系。结果：30例患者中缓解组20例，非缓解组10例；化疗前与化疗后早期病灶大小进行比较，均未见明显变化。化疗前及化疗后早期CT各灌注参数在两组中均有变化。缓解组结核的治疗前PF、BF值高于未缓解组，其差异有统计学意义（t=6.23，t=7.61；P＜0.001），缓解组中结核病灶灌注值治疗前后有显著性差异，灌注值有所下降，未缓解组中治疗前后结核病灶灌注值升高，BF值治疗前14.06＆#177;4.09，治疗后升至36.68＆#177;4.41，其差异显著。PF值虽轻度升高，但无显著性差异。结论：320排双入口灌注技术对肺结核化疗后早期疗效的评估有一定的价值。肺结核治疗后的灌注值变化与近期疗效相关，BF值升高提示结核病灶进展，预后较差。

Research on the 320 detector CT double-input perfusion imaging in estimate of the efficiency of chemotherapy for tuberculosis

Objective：To explore the use of double- entry 320 -slice CT perfusion imaging techniques to assess the effect of tuberculosis perfusion parameters to predict short-term effect of tuberculosis chemotherapy.Methods： Divided 30 cases of tuberculosis into three groups. Compare the two results of one week pre chemotherapy and post chemotherapy with 30d CT scan, divided into clinical remission group and non-remission group according to the standard of evaluating the effect. One week before chemotherapy and after chemotherapy 14d twice CT perfusion scan, comparing with pre and post chemotherapy relationship changes of early CT perfusion parameters.Results： In 30 patients there were 20 cases of remission and 10 cases of non-remission. In 30 patients, compared early lesion size pre chemotherapy and post chemotherapy, there were no significant changes： chemotherapy before and after chemotherapy early CT perfusion parameters in both groups were changed. PF and BF of TB treatment before remission group was higher than the non-remission group before treatment, BF14.06 ＆#177; 4.09, the difference was statistically significant （t=6.23,7.61,P=0.001）, remission group tuberculosis perfusion values before and after treatment there was a significant difference in perfusion values decline, and no relief after perfusion values tuberculosis treatment group increased BF values before treatment after treatment rose to 36.68 ＆#177; 4.41, the difference was statistically significant. PF value is slightly elevated. It is no significant difference.Conclusion： It was valuable that 320 double row of perfusion technique for assessing early entrance efficacy of tuberculosis chemotherapy after a certain. Changes in pulmonary perfusion after treatment with short-term effect related, BF increased indicated that the tuberculose focus has progressed and a poor prognosis.