%0 Journal Article
%T 320排容积CT双血供灌注评估肺占位性病变的良恶性及与微血管密度的相关性
%A 刘慧
%A 林江△
%A 陆秀良
%A 顾君英
%A 姚家美
%J 复旦大学（医学报）
%D 2016
%X 目的 评价肺占位性病变双重血供CT灌注(dual-input CT perfusion,DI-CTP)的可重复性、鉴别良恶性病变的能力及与病变微血管密度(microvessel density,MVD)的相关性。方法116例经病理证实的肺占位性病变患者接受320排容积CT的DI-CTP检查,由两名观察者单独进行DI-CTP参数测量,获得病变的肺动脉血流量(pulmonary flow,PF)、支气管动脉血流量(bronchial flow,BF)及血流灌注指数(perfusion index,PI),并计算灌注总量(total perfusion,TPF)。评价观察者内及观察者间的可重复性;分析良恶性病变DI-CTP参数的差异;并对其中94例外科手术切除病灶进行CD34免疫组化染色分析DI-CTP参数与MVD间的相关性。结果 观察者间和观察者内的可重复性达到良好以上(ICC>0.90)。良恶性肺占位的BF、PF、PI差异有统计学意义(P<0.05),其中PI的ROC曲线下面积为0.936。良恶性肺占位间的MVD差异具有统计学意义(P<0.05);BF、PF及TPF与MVD呈正相关。结论 320排容积DI-CIP可重复性良好,其参数可反映肺占位性病变的血管生成情况,并为鉴别肺占位的良恶性提供依据。</br>Objective To investigate the reproducibility of dual-input CT perfusion (DI-CTP) of lung lesions with 320-detector-row CT,its value in differentiation of malignant and benign lesions and the correlation between CTP parameters and microvessel density (MVD). Methods One hundred and sixteen patients with various lung lesions confirmed later by pathology underwent DI-CTP with 320-detector-row CT.The pulmonary trunk and the descending aorta were selected as input arteries for measuring contributions from pulmonary and bronchial circulation to the lesions.Pulmonary flow (PF),bronchial flow (BF),and perfusion index (PI) were recorded by two independent radiologists,and then total perfusion (TPF) was calculated.Intraclass correlation coefficient (ICC) and Bland-Altman statistics were used to evaluate intra-and inter-observer agreement.DI-CTP parameters were compared between malignant and benign lesions.The correlation between DI-CTP and MVD was analysed in 94 cases of lesions with immunohistochemical staining of CD34.Results Both intra- and inter-observer agreements were good to excellent (ICC>0.90).PF and PI of benign lesions were higher than those of malignant lesions.BF of malignant lesions was higher than that of benign lesions.Statistically significant differences of BF,PF and PI were found between malignant and benign lesions (P<0.05) with the area under the ROC curve of PI being 0.936,the largest of the three perfusion parameters.There was statistically significant difference in MVD between benign and malignant lesions (P<0.05).BF,PF and TPF values were positively correlated with MVD .Conclusions DI-CTP is reproducible and reflects the angiogenesis of lung lesions.It can provide additional information for differential diagnosis of malignant from benign lung lesions.
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%K lung lesions CT perfusion dual-input reproducibility micro-vessel density
%U http://jms.fudan.edu.cn/CN/abstract/abstract1266.shtml