肺部鳞癌、腺癌和小细胞性肺癌128层螺旋CT低剂量灌注的差异性研究

摘要

AIM:To investigate the difference of lung squamous cell carcinoma, adenocarcinoma and small cell lung carcinoma with 128⁃slice spiral CT perfusion of low dose. METHODS:Tumos focus of 81 patients with lung cancer was examined by the 70 kV·50 mAs of 128⁃slice spiral CT perfusion scanning of low dose. The time to peak of the agent (TTP), blood flow (BF), blood volume (BV), permeability (PMB) value of the tumors were estimated according to the model of non⁃deconvolution meth⁃od. The results were analyzed by variance and LSD. RESULTS:The TTP values of squamous cell carcinoma, adenocarcinoma and small cell carcinoma were respectively 15. 62, 17. 91 and 16. 89;the BF ( mL/100 mL/min) values of squamous cell carcinoma, adenocarcinoma and small cell carcinoma were respectively 89.34, 77.27 and 96.49;the BV ( mL/100 mL) values of squamous cell carcinoma, adenocarcinoma and small cell carcinoma were 8.06, 8.94 and 11.95; the PMB (mL/100 mL/min) values of squa⁃mous cell carcinoma, adenocarcinoma, small cell carcinoma of were respectively 13. 79, 15. 17 and 13. 95. TTP values between squamous cell carcinoma and adenocarcinoma were statistically significant ( P<0.05); BF values between adenocarcinoma and small cell carcinoma were statistically significant(P<0.05); BV values between adenocarcinoma or squamous cell carcinoma and small cell carcinoma were statistically significant ( P<0. 05 ) . CONCLUSION:128⁃slice spiral CT with low dose perfusion is feasible in the perfusion of lung cancer. The TTP between squamous cell carcinoma and adenocarcinoma, the BF between adenocarcinoma and squamous cell carcinoma and the BV between adenocarcinoma or squamous cell carcinoma and small cell carci⁃noma have statistically significant difference(P<0.05). The PMB between squamous cell carcinoma and small cell lung cancer, adenocarcinoma and small cell carcinoma have no statistically significant difference( P>0.05) .%目的：探索肺部鳞癌、腺癌和小细胞性肺癌128层螺旋CT低剂量灌注值的差异．方法：对81例肺癌的肿瘤病灶进行70 kV·50 mAs 128层螺旋CT低剂量灌注扫描．根据非去卷积模型法分别获得肿瘤的对比剂达峰时间（ TTP ）、血流量（ BF）、血容量（ BV）、毛细血管通透性（ PMB）相应灌注图并测量TTP、BF、BV、PMB值．将结果分别进行多组比较和组与组之间两两比较，多组比较采用方差分析，组与组之间比较采用LSD法．结果：81例肺部鳞癌、腺癌和小细胞性癌均获得70 kV·50 mAs 128层螺旋CT低剂量灌注的灌注彩图和灌注值．鳞癌、腺癌、小细胞性癌的 TTP（s）分别是：15．62、17．91、16．89；鳞癌、腺癌、小细胞性癌的 BF（mL／100 mL／min）分别是：89．34、77．27、96．49；鳞癌、腺癌、小细胞性癌的BV（ mL／100 mL）分别是：8．06、8．94、11．95；鳞癌、腺癌、小细胞性癌的 PMB （ mL／100 mL／min）分别是：13．79、15．17、13．95．多组比较，差异有统计学意义（P＜0．05）；组与组之间比较结果：鳞癌与腺癌的TTP 对比，差异有统计学意义（P＜0．05）；腺癌与小细胞性癌的BF对比，差异有统计学意义（ P＜0．05）；鳞癌与小细胞性肺癌、腺癌与小细胞性癌的 BV 对比，差异有统计学意义（ P＜0．05）．结论：128层螺旋CT低剂量灌注扫描在肺肿瘤的灌注应用中是可行的；肺部鳞癌、腺癌和小细胞肺癌的部分CT低剂量灌注值存在差异．