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目的探讨256层CT全颈部灌注成像对鼻咽癌颈部淋巴结转移的临床应用价值。资料与方法采用256层CT对经临床及病理证实的25例患者行全颈部CT灌注成像,其中鼻咽癌15例,颈部转移淋巴结65枚,同时取颈部正常肌肉组(65枚淋巴结);结节性甲状腺肿10例,颈部有未转移淋巴结55枚。记录转移淋巴结、未转移淋巴结及颈部正常肌肉的灌注参数值[灌注(P)、血流量(BF)、血容量(BV)、达峰时间(TTP)],并比较各灌注参数值在转移淋巴结与未转移淋巴结及正常肌肉间的差异。结果转移淋巴结组、正常肌肉组及未转移淋巴结组P值中位数分别为32.54HU、8.04HU和20.92HU,PEI均数分别为36.14HU、14.74HU和35.95HU,TTP值均数分别为36.35s、53.05s、48.65s,BV值中位数分别为31.17ml/100g、8.28ml/100g和18.98ml/100g。转移淋巴结P值、PEI值与BV值均高于正常肌肉组织(P<0.01),TTP值小于正常肌肉组织(P<0.01)。转移淋巴结与未转移淋巴结间P值、PEI值、BV值差异无统计学意义(P>0.05),转移淋巴结TTP值小于未转移淋巴结(P<0.01)。结论 256层CT能对所有颈部淋巴结进行灌注成像研究,TTP值对判定鼻咽癌颈部淋巴结转移有一定价值。
Objective To investigate the clinical value of 256-slice CT whole neck perfusion imaging in cervical lymph node metastasis of nasopharyngeal carcinoma. Materials and Methods 25-slice CT was performed in 25 patients with clinically and pathologically confirmed CT perfusion imaging, including 15 cases of nasopharyngeal carcinoma and 65 cases of cervical lymph node metastasis. At the same time, 65 normal cervical lymph nodes ); Nodular goiter in 10 cases, there are 55 non-metastatic lymph nodes in the neck. The perfusion parameter values (perfusion, BF, BV, TTP) of metastatic lymph nodes, non-metastatic lymph nodes and normal muscles in the neck were recorded. Differences between lymph nodes and non-metastatic lymph nodes and normal muscles. Results The median P values of metastatic lymph node group, normal muscle group and non-metastatic lymph node group were 32.54HU, 8.04HU and 20.92HU, respectively. The average PEI values were 36.14HU, 14.74HU and 35.95HU, respectively. The mean values of TTP were 36.35 s, 53.05s, 48.65s and BV were 31.17ml / 100g, 8.28ml / 100g and 18.98ml / 100g, respectively. P value, PEI value and BV value in metastatic lymph nodes were higher than those in normal muscle tissue (P <0.01), and TTP values were lower than normal muscle tissue (P <0.01). There were no significant differences in P value, PEI value and BV value between metastatic lymph nodes and non-metastatic lymph nodes (P> 0.05). The TTP of metastatic lymph nodes was less than that of non-metastatic lymph nodes (P <0.01). Conclusion 256-slice CT perfusion imaging of all cervical lymph nodes, TTP value for the determination of cervical lymph node metastasis of NPC has some value.