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目的探讨多层螺旋CT(MSCT)灌注成像评价非小细胞肺癌(non-small cell lung cancer,NSCLC)病理特征的价值。资料与方法对44例NSCLC患者行MSCT灌注扫描,用多元相关分析探讨灌注参数与病理特征的关系,再分亚组进行趋势检验。结果灌注参数与NSCLC病理特征相关,血流量(BF)和强化峰值(PEI)随分化程度减低而降低(P值分别为0.009与0.021);有淋巴结转移组的BF和PEI明显低于无淋巴结转移组(P值分别为0.000与0.002);PTNM低分期组BF值明显低于高分期组(P=0.000);术后转移或复发组BF值明显低于未转移或复发组(P=0.000);不同病理类型灌注参数无明显差别。结论MSCT灌注成像通过无创性评价血管生成的方式和程度,间接反映肿瘤分化程度,从而预测淋巴结转移和术后转移复发的可能性,是判断NSCLC生物学行为及预后的良好指标。
Objective To investigate the value of multi-slice spiral CT (MSCT) perfusion imaging in evaluating the pathological features of non-small cell lung cancer (NSCLC). Materials and Methods 44 cases of NSCLC patients underwent MSCT perfusion scanning, using multivariate correlation analysis of the relationship between perfusion parameters and pathological features, sub-sub-sub-group for trend test. Results The parameters of perfusion were correlated with the pathological features of NSCLC. The blood flow (BF) and PEI decreased with the decrease of differentiation (P = 0.009 and 0.021, respectively). The BF and PEI in patients with lymph node metastasis were significantly lower than those without lymph node metastasis (P = 0.000 and 0.002, respectively). The BF value in PTNM low staging group was significantly lower than that in high staging group (P = 0.000). The BF value in metastasis or recurrence group was significantly lower than that in non-metastasis or recurrence group (P = 0.000) ; Different pathological types of perfusion parameters no significant difference. Conclusion MSCT perfusion imaging can indirectly predict the degree of tumor differentiation and predict the possibility of lymph node metastasis and postoperative recurrence and metastasis by noninvasively evaluating the manner and extent of angiogenesis. It is a good indicator to judge the biological behavior and prognosis of NSCLC.