摘要
目的 利用 4层螺旋CT动态增强技术定量评价不同性质的明显强化孤立肺结节的血流模式并初步评价血管内皮生长因子 (VEGF)表达阳性的孤立性肺腺癌血管生成与血流模式定量CT参数的相关性。方法 78例孤立明显强化肺结节 (直径≤ 4cm ,6 8例恶性 ,10例活动性炎性 ) ,行多层螺旋CT(MSCT)动态增强 (以 4ml/s的流率注入对比剂 )。记录孤立肺结节增强前后各时相的CT值并计算强化值、灌注值 ,结节 主动脉强化值比。灌注值等于时间 密度曲线最大斜率除以主动脉强化值。其中 30例VEGF表达阳性的肺腺癌患者用免疫组织化学测定微血管密度 (MVD)并标定VEGF ,评价肺腺癌血流模式定量CT参数 (强化值、灌注值、结节 主动脉强化值比及平均通过时间 )与MVD的相关性。结果 恶性结节强化值 (35 79± 10 76 )HU与活动性炎性结节 (39 76± 4 5 9)HU差异无显著意义 (t=1 14 8,P =0 2 5 5 )。恶性结节的结节 主动脉强化值比 (14 2 7± 4 37) %及灌注值 (3 0 2±0 96 )ml-1·min-1·kg-1均低于活动性炎性结节 (18 5 1± 2 71) % ,(6 34± 4 39)ml-1·min-1·kg-1(t =2 978,P =0 0 0 4 ;t=5 5 90 ,P <0 0 0 0 1)。VEGF表达阳性的肺腺癌强化值 (33 0 6± 13 5 7)HU、结节 动脉强化值比 (14 2 5± 4 92 ) %及?
Objective To evaluate the efficacy of dynamic multi-slice spiral computed tomography (MSCT) for providing quantitative information about blood flow patterns of solitary pulmonary nodules (SPNs) and the correlation of vascular endothelial growth factor (VEGF)-positive tumor angiogenesis and the quantifiable parameters of blood flow pattern in solitary bronchogenic adenocarcinoma. Methods(Seventy-eight patients) with SPNs (with strong enhancement) (diameter ≤4 cm; 68 malignant; 10 active inflammatory) underwent multi-location dynamic contrast enhanced (nonionic contrast material was administrated via the antecubital vein at a rate of 4 ml/s by using an autoinjector) serial CT. Precontrast and postcontrast attenuation on every scan was recorded. Perfusion, peak height, and ratio of peak height of the SPN to that of the aorta were calculated. Perfusion was calculated from the maximum gradient of the time-attenuation curve and the peak height of the aorta. The quantifiable parameters (perfusion, peak height, ratio of peak height of the bronchogenic adenocarcinoma to that of the aorta and mean transit time) of blood flow pattern in 30 VEGF-positive solitary bronchogenic adenocarcinoma were compared with microvessel densities (MVD)and VEGF expression by immunohistochemistry . Results No statistically significant difference in the peak height was found between malignant (35.79±10.76) HU and active inflammatory (39.76±4.59) HU nodules (t=1.148, P=0.255). SPN-to-aorta ratio (14.27±4.37)% and perfusion value (3.02±0.96)ml^(-1) ·min^(-1) ·kg^(-1) in malignant SPNs were significantly lower than those of active inflammatory nodules(18.51±2.71)%, (6.34±4.39)ml^(-1) ·min^(-1) ·kg^(-1) (t=2.978, P=0.004, t=5.590 ,P<0.0001). Peak height of VEGF-positive bronchogenic adenocarcinoma was (33.06±13.57) HU, bronchogenic adenocarcinoma-to-aorta ratio(14.25±4.92)%, and perfusion value (2.97±0.56) ml^(-1) ·min^(-1) ·kg^(-1), mean transit time (14.86±5.84)s, and MVD (70.15±20.03). Each of peak height, ratio of peak height of the bronchogenic adenocarcinoma to that of the aorta, and perfusion correlated positively with MVD (r=0.781, P<0.0001;r=0.688, P<0.0001;r=0.716, P<0.0001). No significant correlation was found between mean transit time and MVD (r=0.260, P=0.200). Conclusion(The quantitative) information about blood flow patterns of malignant and active inflammatory SPNs is different. SPN-to-aorta ratio and perfusion value are helpful in differentiating malignant nodules from active inflammatory nodules. Perfusion, peak height, and ratio of peak height of the bronchogenic adenocarcinoma to that of the aorta reflect MVD in VEGF-positive bronchogenic adenocarcinoma. Perfusion, peak height, and ratio of peak height of the bronchogenic adenocarcinoma to that of the aorta derived with dynamic CT might be index for VEGF-related tumor angiogenesis in bronchogenic adenocarcinoma.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2004年第10期1062-1068,共7页
Chinese Journal of Radiology
关键词
肺结节
肺腺癌
灌注
孤立
炎性
血流
恶性
平均
记录
参数
Noevascularization, pathologic
Endothelial growth factors
Lung neoplasms
Coin lesion, pulmonary
Regional blood flow
