肾上腺多层CT灌注成像的临床应用研究

目的:研究肾上腺多层CT灌注成像对于肾上腺病变鉴别诊断的应用价值和病理基础。材料和方法:回顾性研究一组肾上腺病变的多层CT灌注成像,GE ADW4.2后处理工作站计算其灌注参数,包括血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS),并与临床实验室资料和病理结果对照。结果:嗜铬细胞瘤BF和PS明显大于肾上腺腺瘤、肾上腺增生、结核、淋巴瘤和转移瘤。恶性嗜铬细胞瘤PS高于良性嗜铬细胞瘤。肾上腺增生、功能性腺瘤和嗜铬细胞瘤等功能性肾上腺病变的BF、BV和PS高于肾上腺淋巴瘤、结核和转移瘤等功能下降的肾上腺病变。富脂类腺瘤和乏脂类腺瘤的灌注参数无明显差异。肾上腺病变的灌注参数和微血管密度表达有关。结论:多层CT灌注成像反映了肾上腺微血管状况,灌注参数的差异可作为肾上腺病变鉴别诊断的辅助方法。PS值的差异可能有助于良恶性嗜铬细胞瘤的鉴别。

Clinical Study of Adrenal Multi-slice CT Perfusion Imaging

Purpose:To study the value of multi-slice CT perfusion in differential diagnosis of adrenal lesions and the pathological basis.Materials and Methods:A retrospective study of adrenal lesions un- derwent MSCT perfusion scan.The CT perfusion parameters,including blood flow (BF),blood volume (BV),mean transit time (MTT),permeability surface (PS) were analyzed,and the correlation between the parameters and clinic,pathological factors were studied.Results:BF and PS of pheochromocytoma (PCC) were higher than those of adrenal adenoma,adrenal hyperplasia,adrenal tuberculosis,lymphoma and metastasis.Malignant PCC had a higher PS than benign PCC.Tuberculosis,lymphoma and metastasis which had adrenal hypofunction had lower BF,BV,PS than adrenal lesions which had hyperfunction.No difference of BF,BV,MTT and PS between lipid-rich and lipid-poor adenoma.The perfusion param- eters were associated with the microvessel density (MVD) of adrenal lesions.Conclusion:MSCT perfu- sion imaging which may reflect blood flow and MVD of adrenal lesions has potential value of clinical ap- plication to differentiating adrenal lesions.PS would be helpful to distinguish benign or malignant PCC.