目的 通过320排宽探测器CT行SPN低剂量双灌注成像,探讨时间-密度曲线对于SPN的鉴别诊断及临床应用价值.方法 灌注成功并明确诊断的SPN 28例,包括首诊患者及非手术治疗后复查患者.采用40ml对比剂(优维显,370mgI/ml),生理盐水40ml,注射速度为6m/s.扫描数据经东芝Aquilion ONE 320排宽探测器CT后处理,所得13个数据包,采用腹部灌注软件处理这13个数据包,分析得出肺动脉、支气管动脉、SPN及降主动脉曲线图.结果 恶性SPN的TDC上升期分别与肺动脉TDC上升期、支气管动脉TDC上升期的交集时间的差异符合统计学意义( P <0.05).ROC曲线下面积0.778,临界值35.35HU,灵敏度66.7%,特异度91.0%( P <0.05).结论 320排宽探测器CT低剂量双灌注成像提供了SPN客观的血供情况,对于SPN的良恶性鉴别诊断具有较大指导意义.%Objective To evaluate the clinical application of time-density curves(TDC) in diagnosis of SPN with 320-detec-ter computer tomography low-dose dual perfusion imaging. Methods There were 28 cases of SPN confirmed by pathological di-agnosis and successfully examined by 320-detecter computer tomography low-dose dual perfusion imaging, including first clinical patients and patients with non-surgical treatment after review. All CT examinations were performed using 320-detecter computer tomography (Aquilion ONE,Toshiba Medical Systems),a bolus of 40 ml contrast agent(Ultravist,370 mgI/ml),followed by 40 ml saline at a flow rate of 6 ml/sec. Scan data included 13 packets and all packets were analyzed with abdominal perfusion soft-ware,acquired pulmonary artery,bronchial artery,pulmonary nodules and descending aorta time-density curves. Results There were significant differences in rising time of TDC among malignant SPN,pulmonary artery and bronchial artery( P <0.05). The receiver operating characteristic(ROC) curve was 0.778,the critical value was 35.35 HU,the sensitivity and the specificity was 66.7% and 91.0%,respectively ( P <0.05). Conclusion 320-detecter computer tomography low-dose dual perfusion ima-ging provides objective blood supply situation of a nodule, and has important guiding role in diagnosis of benign and malignant SPN.
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