摘要
目的 初步探讨多层螺旋CT(MSCT)动态增强评价恶性孤立性肺结节血流模式的技术方法。方法 5 7例恶性孤立性肺结节 (直径≤ 4cm)患者 ,经屏气训练后 ,在增强前、后采用MarconiMx80 0 0多层螺旋CT进行扫描 ,以 4ml/s的速度从肘静脉注入非离子型造影剂 90ml,动态扫描选择肺结节最大层面进行。其中 2 9例于第 15～ 45s、75～ 10 5s时 ,每间隔 1s扫描一次 (程序 1) ;2 8例于第 11～ 41s、71～ 10 1s时 ,每间隔 1s扫描一次 (程序 2 ) ;两组患者均于 2～ 9min时每间隔 3 0s扫描一次。病灶直径为 3～ 4cm时 ,扫描层厚5mm ;病灶直径≤ 3cm时 ,扫描层厚 2 .5mm ,以常规算法重建图像。记录孤立肺结节增强前后各时相的CT值并计算强化值、灌注量、结节 主动脉强化值比、平均通过时间。结果 两组患者所得强化值、灌注量、结节 主动脉强化值比、平均通过时间均无统计学差异 (P =0 .5 16,P =0 .60 9,P =0 .3 5 6,P =0 .693 )。程序 1只测得部分患者 ( 2 2 / 2 9)的结节平均通过时间 ;程序 2得到了全部患者 ( 2 8/ 2 8)的结节平均通过时间。结论 多层螺旋CT(MSCT)动态增强是定量评价恶性孤立性肺结节血流模式的无创性技术 ,具有研究肺癌血管生成的潜在价值。
Objective To investigate the methods of dynamic enhanced multi slice spiral CT in the evaluation of blood flow patterns of malignant solitary pulmonary nodules (SPNs). Methods Fifty seven patients with malignant SPNs (≤4 cm) underwent dynamic multi slice spiral CT (Marconi Mx8000) scan before and after contrast enhancement by injecting 90 ml contrast material with a rate of 4 ml/s. Twenty nine patients in protocol one were scanned every 2 seconds during 15 45 seconds and 75 105 seconds after injection, while 28 patients in protocol two were scanned every 2 seconds during 11 41 seconds and 71 101 seconds. All patients were then scanned every 30 seconds during 2 9 minutes. The collimation was 2.5 mm for lesions of ≤3 cm and 5 mm for lesions of 3 4 cm. Standard algorithm was used in the image reconstruction. The perfusion, peak height, ratio of peak height of the SPN to that of the aorta and mean transit time were calculated. Results The enhancement value, perfusion, ratio of peak height of the SPN to that of the aorta and mean transit time were (34.61±11.37) HU, (31.17±11.18) ml/(min·100 g), 13.90%±4.15%, (13.96±5.86) s separately in protocol one, and (36.54±10.89) HU, (29.80±8.80) ml/(min·100 g), 15.01%±4.83%, (13.34±5.12) s respectively in protocol two. No statistically significant difference was found between the two groups. In addition, mean transit time from all 28 patients in protocol two were obtained, but only part of them were measured in protocol one (22/29). Conclusion Dynamic enhanced multi slice spiral CT is a kind of non invasive method for quantitative evaluation of blood flow patterns of malignant solitary pulmonary nodules. It might have potential significance in angiogenesis research for lung cancer.
出处
《中国肺癌杂志》
CAS
2003年第1期18-21,共4页
Chinese Journal of Lung Cancer
