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目的:采用能谱CT技术对肺癌癌周灌注进行定量研究,探讨其灌注变化情况及不同分类情况下的灌注差异。方法:经病理证实的81例肺癌患者均行能谱CT平扫和增强扫描。在动脉期碘基物质图上分别测量癌周肺组织及健侧镜像区肺组织碘基值,然后计算平均碘浓度(average iodine concentration,ICa),分析比较:所有病例组、中央型及周围型肺癌组癌周与健侧镜像区肺组织的ICa差异;不同部位(中央型、周围型)、肿瘤大小(A组:d≤3 cm、B组:30.05)。(3)不同大小肺癌之间以及不同分化程度肺癌之间癌周肺组织ICa差异均无统计学意义(P>0.05)。结论:肺癌癌周灌注普遍减低,且中央型肺癌低于周围型肺癌,小细胞肺癌低于非小细胞肺癌。肺癌癌周能谱CT灌注特征具有一定理论和临床价值。
OBJECTIVE: To quantitatively study peri-perfusion of lung cancer by energy spectrum computed tomography (CT), investigate the perfusion changes and perfusion differences under different classification. Methods: 81 cases of pathologically confirmed lung cancer patients underwent both CT scan and enhanced scan. The iodine value in the lung tissue of lung cancer tissues and the contralateral lung was measured respectively on the iodine material map of arterial phase and then the average iodine concentration (ICaA) was calculated. The analysis and comparison: All cases, central and peripheral The difference of ICa between the lung cancer group and the contralateral lung cancer group was significant (P <0.05) Squamous cell carcinoma, adenocarcinoma, small cell lung cancer) and the degree of differentiation (low, low - moderate and moderately differentiated) lung cancer group within the ICa group. Results: (1) 81 cases of lung cancer (1.26 ± 0.42 mg / m L), 32 cases of central type (1.12 ± 0.33 mg / m L) and 49 cases of peripheral type (1.35 ± 0.45 mg / m L ] The ICa of lung tissue in lung cancer was significantly lower than that in corresponding contralateral [(1.65 ± 0.61) mg / m L, (1.63 ± 0.69) mg / m L and (1.66 ± 0.56) mg / m L] Statistical significance (P <0.01). (2) ICa [(1.12 ± 0.33) mg / m L] was significantly lower than that of peripheral type [(1.35 ± 0.45) mg / m L] The expression of ICa in the lung tissue was lower than that in 37 squamous cell carcinomas [(1.23 ± 0.40) mg / m L] and 34 adenocarcinomas [(0.94 ± 0.20) mg / m L] <0.05), but there was no significant difference between them (P> 0.05). (3) There was no significant difference in ICa of lung tissue between different sizes of lung cancer and between different degrees of differentiation of lung cancer (P> 0.05). CONCLUSION: Pericardial perfusion of lung cancer is generally reduced, and central lung cancer is lower than peripheral lung cancer, and small cell lung cancer is lower than non-small cell lung cancer. The CT perfusion characteristics of the spectrum of lung cancer have certain theoretical and clinical value.