摘要
目的:探讨16层螺旋CT首过动态增强CT在确定肺孤立结节(SPN)良恶性中的价值并与SPN微血管密度对照分析,阐述首过动态增强CT评价SPN良恶性的分子生物学基础。方法:75例SPN行首过动态增强CT扫描,61例进入研究范围。记录肺SPN首过强化峰值(PH),其中40例SPN标本用免疫组化(S-P法)测定微血管密度(MVD),评价首过PH值与MVD的相关性。结果:良性结节MVD(14.333±10.577条/0.723mm2)、首过PH值(10.912±5.452)HU,均小于恶性结节MVD(32.821±19.459条/0.723mm2)、首过PH值(22.864±13.514)HU。40例良恶性结节首过PH值与MVD呈正相关(r=0.821),首过PH值诊断结节良恶性的最佳界值点为15HU,对孤立结节良恶性的诊断,首过PH值诊断的敏感度、特异度、符合率、阳性、阴性预测值分别为87.5%、72.41%、77.78%、84.00%、80.33%。结论:胸部首过动态增强CT可有效评价SPN良恶性。首过PH值准确反映SPN微血管密度是首过动态增强CT有效评价SPN良恶性的分子生物学基础。
Objective：To evaluate the efficacy of the first pass dynamic enhanced technique with 16-slice spiral CT for the differentiation of benign from malignant solitary pulmonary nodules（SPNs）and to correlate the imaging findings with microvessel density（MVD）of tumor as well as to illustrate the basis of molecular biology in the differential diagnosis.Methods：72 patients with SPNs underwent first pass dynamic enhanced technique with multi-slice spiral computed tomography（MSCT）.61 patients were included into the study.The peak height（PH）of the first pass was measured.The first pass PH of 40 SPNs were compared with their specimen for microvessel densities（MVDs）by immunohistochemistry with SP technique.The relationship was assessed by means of linear regression analysis.Results：The mean MVD（32.821±19.459/0.723mm^2）and the first pass PH（22.864±13.514）HU of malignant SPNs were significantly higher than those of benign ones（14.333±10.577/0.723mm^2 and 10.912±5.452HU）respectively（P〈0.01）.Each first pass PH of these 40 SPNs was correlated positively with MVDs（r=0.821）.Taken 15HU for the first pass PH as the cutoff value in the differentiation for malignant and benign SPNs,the sensitivity,specificity,accuracy,positive predictive value,negative predictive value were 87.5%、72.41%、77.78%、84.00%、80.33% respectively.Conclusion：The first pass dynamic contrast enhanced CT technique proved to be useful in the differentiation of benign from malignant SPNs.The MVDs of the SPNs could be evaluated accurately by the PH of the first pass,which is the molecular biology basis of the first pass dynamic enhanced MSCT in the differential diagnosis.
出处
《放射学实践》
2008年第9期999-1003,共5页
Radiologic Practice
