目的 分析良、恶性淋巴结病变的CT灌注时间-密度曲线(TDC)形态变异情况及其临床意义.方法 对60例纵隔、腹盆腔淋巴结病变患者行双源螺旋CT灌注检查.所有病例均取得手术或穿刺病理诊断结果,包括良性淋巴结病变11例,恶性淋巴结病变49例.观察CT灌注TDC特征,与病理结果对照,分析曲线形态变异情况及临床相关性.结果 淋巴结病变CT灌注TDC在不同阶段有多种变异形态,良、恶性淋巴结病变TDC在上升速度、上升方式、有无平台期、下降速度方面的差异有统计学意义(均P＜0.05)；而在开始增强时程、灌注峰值、下降方式方面的差异无统计学意义.结论 对淋巴结病变行CT灌注诊断时,分析TDC各个阶段的变异特征,有利于鉴别诊断良、恶性淋巴结病变.%To analyze the morphological changes of time-density curve (TDC) in CT perfusion of benign and malignant lymphadenopathy, and to investigate its clinical significance. Methods Sixty patients with mediastinum and/or celiac lymphadenopathy underwent CT perfusion examination. All patients had been pathologically diagnosed with operation or biopsy. There were 11 patients with benign lympadenopathies and 49 patients with malignant lymphadenopathy. The features of CT perfusion TDC morphosis were observed and compared with pathology results, and the relationship of TDC morphosis with its underlying clinical pathology causes was analyzed. Results TDC of lymphadenopathy had diverse morphosis. Obvious differences of TDC morphosis in curve upgrade speed, upgrade pattern, with or without platform and descent speed were found between benign and malignant lymphadenopathies (all P<0. 05). However, there were crossed TDC features in enhance starting speed, perfusion peak value and descend pattern between benign and malignant lymphadenopathies. Conclusion Analyzing the morphological changes of TDC would benefit for CT perfusion differential diagnosis of benign and malignant lymphadenopathy.
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