肺部孤立性病变CT灌注参数与MVD相关性分析-Correlation between MSCT perfusion parameters and microvessel density in solitary pulmonary lesions

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【摘要】目的：探讨肺部孤立性病变多层螺旋CT（MSCT）灌注成像参数与肿瘤微血管密度（MVD）间的关系，评价MSCT灌注成像对肺部孤立性病变的鉴别诊断价值。方法：80例经病理证实的肺部孤立性病变患者行MSCT灌注成像检查，计算血流量（BF）、血容量（BV）、平均通过时间（MTT）、毛细血管通透性（PS）；采用CD34单抗标记测定MVD，分析良、恶性病变、炎性病变、不同分化程度肿瘤组织的CT灌注参数差异及各参数与MVD间的相关性。结果：良、恶性和炎性病变组的BV分别为(3.45±1.75)、（10.40±4.08）、（8.40±8.42）mL/100g；BF分别为(24.48±18.74)、（77.75±43.03）、（84.54±107.13）mL/(100g·min)；PS分别为(4.33±2.90)、（21.70±10.86）、（14.67±10.29）mL/(100g·min)；MTT分别为(15.54±7.01)、（15.23±13.35）、（12.55±8.39）s。良性组与恶性组、良性组与炎性组BF、BV、PS值差异均具有统计学意义（P＜0.05）；恶性组与炎性组间仅PS差异具有统计学意义（P＜0.05），MTT均无相关性(P>0.05)。MVD在非小细胞肺癌不同分化程度鉴别方面具有统计学意义。BF、BV、PS与MVD呈正相关(P0.05)。结论：MSCT灌注成像可间接反映活体肺部孤立性病变血管生成情况，为鉴别肺部孤立性病变良恶性和治疗、预后评估提供依据。;【Abstract】Objective:To observe the correlation between MSCT perfusion parameters and microvessel density (MVD),and to evaluate the diagnostic value of CT perfusion in differentiating the solitary pulmonary lesions.Methods:80 cases of solitary pulmonary lesions proved by pathology underwent CT perfusion. Blood flow(BF),blood volume (BV),mean transit time(MTT) and permeability surface(PS) were caculated. To measure the MVD using CD34 labeled monoclonal antibody.To compare MSCT perfusion parameters between malignant tumors of different grades,benign, malignant and inflammatory lesions. To analyse the correlation between MSCT perfusion parameters and MVD.Results:The BF value of benign, malignant and inflammatory lesions was (3.45± 1.75)、（10.40±4.08）、(8.40±8.42）mL/100g,respectively; the BV value was (24.48±18.74)、（77.75±43.03）、（84.54±107.13）mL/(100g•min) ,respectively；the PS value was (4.33±2.90)、（21.70±10.86）、（14.67±10.29）mL/(100g•min) ,respectively；the MTT value was (15.54±7.01)、（15.23±13.35）、（12.55±8.39）s,respectively；The differences of BF,BV,PS between benign and malignant lesions,benign and inflammatory lesions were statistically significant（P＜0.05）.Only the difference of PS between malignant and inflammatory lesions was statistically significant（P＜0.05）. There were no significant differences in MTT between the three groups (P＞0.05)．There was statistically difference in MVD between different grades of non small cell lung cancer (P＜0.05).BF、BV、PS were positive correlated with MVD (r=0.316,0.886,0.617，P<0.05).There was no correlation between MTT and MVD (P＞0.05)．Conclusion:MSCT perfusion can reflected the angiogenesis of solitary pulmonary lesions in vivo inderectly, and can provide evidences for the differential diagnosis,optimization of a reasonable treatment protocol,the evaluation of curative effect and the prognosis.