MSCT灌注成像对周围型肺腺癌的诊断价值及临床意义

目的探讨多层螺旋CT（MSCT）灌注成像对肺腺癌的诊断价值及临床意义。资料与方法回顾性分析经病理证实的269例肺腺癌患者的MSCT灌注参数与影像特征,用多元相关分析探讨灌注参数与病理特征的关系,再分组进行趋势检验。结果灌注参数与周围型肺腺癌影像特征相关,血流量（BF）和强化峰值（PEI）随分化程度减低而降低（P值分别为0.012与0.024）;有淋巴结转移组的BF和PEI明显低于无淋巴结转移组（P值分别为0.002与0.003）;PTNM低分期组BF值明显低于高分期组（P=0.001）;术后转移组BF值明显低于未转移组（P=0.001）。结论 MSCT灌注成像通过无创性评价血管生成的方式和程度,间接反映肿瘤分化程度,从而预测淋巴结转移和术后转移复发的可能性,是判断周围型肺腺癌生物学行为及预后的良好指标。

The diagnosis and clinical significance of multi-slice spiral CT pulmonary perfusion imaging in peripheral pulmonary adenocarcinoma

Objective：To investigate the diagnosis and clinical significance of lung adenocarcinoma with the multi-slice CT（MSCT） perfusion imaging.Methods： Retrospective analysis was made of MSCT perfusion parameters and image features of 269 patients with pathologically confirmed lung cancer patients,using multivariate analysis of perfusion parameters and pathological features,and then in groups trend test was done.Results： Perfusion parameters and imaging features of peripheral lung cancer were related.Blood flow（BF） and peak enhancement（PEI） decreased with the lower degree of differentiation（P=0.012 and 0.024）;BF and PEI of lymph node metastasis group was significantly lower than those with no lymph node metastasis（P values were 0.002 and 0.003）;BF of PTNM in the low stage group was significantly lower than that in the high stage group（P=0.001）;BF of postoperative metastasis group was significantly lower than that without metastasis（P=0.001）.Conclusion： MSCT perfusion imaging reflects the degree of tumor differentiation indirectly to predict lymph node metastasis and the possibility of metastasis recurrence after surgery by non-invasive,which is a good indicator to judge the biological behavior and prognosis of peripheral lung adenocarcinoma.