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- 2018
首过期双输入模型容积CT灌注成像在肺结节诊断中的价值
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Abstract:
摘要 目的:探讨320排动态容积CT首过期内双输入肺灌注成像对肺结节诊断的临床应用价值.方法:收集因肺部疾病需要进行增强扫描的133例患者,包括36例炎性肺结节和97例恶性肺结节,采用东芝320排CT对其进行首过期容积灌注成像,采用自适应迭代重建方法进行图像重建,并使用双输入数学模型最大斜率法进行灌注指数的定量分析,采用感兴趣区(ROI)技术测量肺结节及正常肺组织的肺动脉血流量(PAF)、支气管动脉血流量(BAF),比较正常肺组织及不同肺内病灶的肺循环和体循环血流构成比的差异.结果:肺部CT灌注成像总的最大有效剂量为6.47 mSv;36例炎性肺结节的PAF均值为(140.6±50.8)mL/min/100mL,BAF均值为(28.1±27.3)mL/min/100 mL;97例恶性肺结节的PAF均值为(53.1±25.2)mL/min/100 mL,BAF均值为(84.4±20.6)mL/min/100 mL;133例患者在病灶对侧同层面正常肺组织的PAF值为(130.6±20.8)mL/min/100 mL;BAF值为(1.6±2.7)mL/min/100 mL.3者之间的灌注参数差异具有统计学意义(P<0.05).结论:320 排动态容积CT灌注成像技术能评估肺组织及肺结节肺循环和体循环血流构成比情况,对恶性及炎症性肺结节的鉴别诊断具有一定的参考意义.
[1] | 方进, 毛家骥, 梁敏杰, 等.320排动态容积CT对正常人肺实质不同区域灌注定量研究. 临床放射学杂志, 2016,35(10):1593-1597. |
[2] | FANG J,MAO J J,LIANG M J,et al.A quantitatively pilot study of pulmonary perfusion of healthy people by using 320-detector row dynamic volumetric CT[J]. Journal of Clinical Radiology, 2016,35(10):1593-1597. |
[3] | 吴瑶媛, 王万勤, 刘斌, 等. FBP、ASiR和VEO三种重建算法对常规剂量胸部CT图像质量的影响[J]. 中国医学影像技术, 2012,28(3):575-578. |
[4] | 李慎江, 肖湘生, 刘士远, 等. 肺结节的不均匀灌注[J]. 中华放射学杂志, 2008,42(8):862-865. |
[5] | LI S J,XIAO X S,LIU S Y,et al.The inhonmogeneous perfusion of the solitary pulmonary nodules[J]. Chin J Radio, 2008,42(8):862-865. |
[6] | SHU S J, LIU B L, JIANG H J.Optimization of the scanning technique and diagnosis of pulmonary nodules with first-pass 64-detector-row perfusion VCT[J]. Clinical Imaging, 2013,37(2):256-264. |
[7] | MILES K A, HAYBALL M P, DIXON A K.Functional images of hepatic perfusion obtained with dynamic CT[J]. Radiology, 1993,188(2):405-411. |
[8] | JEONG Y J, LEE K S, JEONG S Y, et al.Solitary pulmonary nodule: characterization with combined wash-in and washout features at dynamic multi-detector row CT[J].2005,237(2):675-683. |
[9] | 侯铁, 杨淑琴, 张春雨, 等. 孤立性肺结节CT灌注成像扫描技术及诊断的探讨[J].中国实验诊断学,2008,12(11):1400-1402. |
[10] | HOU T, YANG S Q, ZHANG C Y,et al.To evaluate the solitary pulmonary nodules of CT perfusion imaging[J]. Chin J Lab Diagn, 2008,12(11):1400-1402. |
[11] | LI Y, YANG Z G, CHEN T W, et al.Peripheral lung carcinoma: correlation of angiogenesis and first-pass perfusion parameters of 64-detector row CT[J]. Lung Cancer, 2008,61(1):44-53. |
[12] | ZHU C S, YANG J, LV Q, et al.Evaluation of blood flow patterns for first time of solitary pulmonary nodules with multi-slice spiral CT perfusion imaging[J]. Chinese Imaging Journal of integrated Traditional and Western Medicine, 2010,8(4):305-308. |
[13] | 白荣杰, 韩铭钧, 王立平, 等. CT灌注成像在孤立性肺结节中的应用[J]. 中国医学影像技术, 2004,20(6):866-869. |
[14] | BAI R J, HAN M J, WANG L P, et al.CT perfusion imaging in solitary pulmonary nodule[J]. Chin J Med Imaging Technol, 2004, 20(6):866-869. |
[15] | DEWAN N A, GUPTA N C, REDEPENNING L S, et al.Diagnostic efficacy of PET-FDG imaging in solitary pulmonary nodules. Potential role in evaluation and management[J]. Chest, 1993,104(4):997-1002. |
[16] | MAZERON R, BOURHIS J, DEUTSCH E.Angiogenesis: all a radiation oncologist should know[J]. Cancer Radiother, 2008,12(1):50-60. |
[17] | 白荣杰, 程晓光, 申宝忠, 等. 64层CT灌注成像对孤立性肺结节微血管结构的评价[J]. 临床放射学杂志, 2008,27(8):1032-1037. |
[18] | BAI R J,CHENG X G,SHEN B Z,et al.Evaluation of mierovessel structure of solitary pulmonary nodules wiUl 64-slice spiral CT perfusion imaging[J]. Journal of Clinical Radiology, 2008,27(8):1032-1037. |
[19] | 刘立雄, 谭理连, 李志铭, 等. 320层容积CT灌注成像诊断肺孤立性结节[J]. 中国医学影像技术, 2013,29(5):722-726. |
[20] | LIU L X, TAN L L, LI Z M, et al.320-detector row CT volume lung perfusion imaging in diagnosis of solitary pulmonary nodule[J]. Chin J Med Imaging Technol, 2013,29(5):722-726. |
[21] | WU Y Y, WANG W Q,LIU B, et al.Impact of reconstruction techniques on routine dose chest CT image quality: comparison of FBP,ASiR and VEO[J]. Chin J Med Imaging Technol, 2012, 28(3):575-578. |
[22] | NG Q S, GOH V, FICHTE H, et al.Lung cancer perfusion at multi-detector row CT: reproducibility of whole tumor quantitative measurements[J]. Radiology, 2006,239(2):547-553. |
[23] | MCCULLAGH A, ROSENTHAL M, WANNER A, et al.The bronchial circulation-worth a closer look: a review of the relationship between the bronchial vasculature and airway inflammation[J]. Pediatr Pulmonol, 2010,45(1):1-13 |
[24] | OHNO Y, KOYAMA H, TAKENAKA D, et al.Dynamic MRI, dynamic multidetector-row computed tomography (MDCT), and coregistered 2-[fluorine-18]-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/CT: comparative study of capability for management of pulmonary nodules[J]. J Magn Reson Imaging, 2008,27(6):1284-1295. |
[25] | 袁小东, 敖国昆, 全昌斌, 等. 肺双重血供的CT灌注技术及其应用于肺结核的初步研究[J]. 中华临床医师杂志(电子版), 2011,5(20): 5913-5918. |
[26] | GARCIA P A, BONALDI V M, BRET P M, et al.Effect of rate of contrast medium injection on hepatic enhancement at CT[J]. Radiology,1996,199(1):185-189. |
[27] | 单飞, 张志勇, 曾蒙苏, 等. CT容积灌注诊断孤立性肺结节良恶性的临床应用评价[J]. 临床放射学杂志, 2011,30(11):1609-1613. |
[28] | SHAN F,ZHANG Z Y,ZENG M S,et al.The evaluation of CT volume based fist pass perfusion in diagnosis of SPNs[J]. Journal of Clinical Radiology, 2011,30(11):1609-1613. |
[29] | BOTENGA A S.The significance of broncho-pulmonary anastomoses in pulmonary anomalies: a selective angiographic study[J]. Radiol Clin Biol, 1969,38(5):309-328. |
[30] | SHAN F, ZHANG Z, XING W, et al.Differentiation between malignant and benign solitary pulmonary nodules: Use of volume first-pass perfusion and combined with routine computed tomography[J]. European Journal of Radiology, 2012,81(11):3598-3605. |
[31] | TORRE L A, SIEGEL R L, JEMAL A.Lung cancer statistics[J]. Adv Exp Med Biol, 2016,893(2):1-19. |
[32] | HOSCH W, STILLER W, MUELLER D, et al.Reduction of radiation exposure and improvement of image quality with BMI-adapted prospective cardiac computed tomography and iterative reconstruction[J]. Eur J Radiol, 2012,81(11):3568-3576. |
[33] | YUAN X D, AO G K, QUAN C B, et al.Dual-input lung perfusion: a new technique and primary outcomes in tuberculosis[J]. Chin J Clinicians, 2011,5(20):5913-5918. |
[34] | 朱才松, 杨军, 吕琦, 等. 多层螺旋CT灌注评价孤立性肺结节首过血流模式[J]. 中国中西医结合影像学杂志, 2010,8(4):305-308. |