目的 观察肺腺癌结节MDCT动态增强表现与肿瘤间质特征间的关系.方法 收集经手术病理证实肺腺癌结节患者33例,术前均接受MDCT平扫及动态增强扫描.记录结节强化值、对比剂廓清值和结节强化分布形态.通过半自动分割软件计算肿瘤内侵犯性(ISPT)和非侵犯性间质比例(NSPT).结果 肺腺癌结节肿瘤内ISPT与结节强化值间呈正相关(r=0.374,P=0.008). NSPT与对比剂廓清值间呈正相关(r=0.216,P=0.006). CT强化早期,肺腺癌结节实性部分强化形态分布与侵犯性间质分布间具有良好的对应性.结论 肺腺癌结节强化值、对比剂廓清值与肿瘤间质成分明显相关.CT动态增强表现会随着肿瘤内间质比例、分布的不同而变化.%To evaluate the correlation between dynamic contrast enhanced MDCT findings of nodular pulmonary adenocarcinoma and tumor stroma characters. Methods Thirty-three patients with nodular pulmonary adenocarcinoma diagnosed by surgery were collected. All patients underwent plain and dynamic contrast-enhanced MDCT before surgery. CT findings were analyzed in terms of wash-in, wash-out of contrast media and distribution of enhancement. Semi-auto segmentation software was used to calculate invasive (ISPT) and noninvasive stroma proportion (NSPT). Results ISPT was correlated positively with wash-in enhancement in pulmonary adenocarcinoma nodules (r=0.374, P=0. 008). NSPT was correlated positively with wash-out enhancement (r=0. 216, P = 0.006). There was good correlation between CT enhancement pattern during wash-in phase and distribution of invasive stroma. Conclusion Wash-in and wash-out of contrast correlates significantly with tumor stroma proliferation in nodular pulmonary adenocarcinoma. Dynamic CT findings could be altered by the degree of different types of stroma in pulmonary adenocarcinoma.
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