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目的研究不同性质甲状腺结节CT灌注成像与微血管密度(MVD)的相关性。方法随机选取52例甲状腺病变患者,良性组40例,恶性组12例,均采用常规CT平扫和同层动态灌注扫描,计算出血流量(BF)、血容量(BV)、表面通透性(PS)、平均通过时间(MTT)及达峰时间(TTP),良恶性甲状腺结节CT灌注参数各值分别与各组病例术后病理免疫组织化学染色的MVD高倍镜下(×400)计数值进行Pearson相关分析,良性组及恶性组甲状腺结节CT灌注参数及MVD采用t检验。结果良、恶性甲状腺结节CT灌注参数BV值分别为(13.97±11.34)ml/100 g、(22.89±11.56)ml/100 g,良、恶性甲状腺结节BV差异有统计学意义(t=2.211,P=0.034<0.05),BF、TTP、PS、MTT差异均无统计学意义(P=0.234、0.112、0.614、0.709);良、恶性甲状腺结节的MVD间存在显著差异(t=7.621,P=0.000<0.001);良性组PS值与MVD间呈正相关(r=0.404,P=0.05),恶性组PS值与MVD间呈负相关(r=-0.601,P=0.039<0.05),其余各指标BF、BV、TTP、MTT与MVD间均无相关性。结论 CT灌注成像可对甲状腺结节微血管血流动力学状况进行量化评估,其各种灌注参数中以BV值对甲状腺良恶性病变的鉴别诊断价值最大,良、恶性甲状腺结节CT灌注参数PS与MVD具有良好的相关性,对术前间接评价肿瘤的血管生成及良恶性有重要价值。
Objective To study the correlation between CT perfusion imaging and microvessel density (MVD) in thyroid nodules of different natures. Methods Fifty-two patients with thyroid disease were randomly selected, 40 patients in benign group and 12 patients in malignant group. All patients underwent routine CT scan and dynamic perfusion scanning to calculate blood flow (BF), blood volume (BV), surface permeability PS), mean transit time (MTT) and time to peak (TTP). The values of CT perfusion parameters in benign and malignant thyroid nodules were respectively compared with the MVD magnification (× 400) in histopathological and immunohistochemical staining Pearson correlation analysis, CT perfusion parameters and MVD of benign and malignant thyroid nodules were analyzed by t-test. Results BV values of benign and malignant thyroid nodules were (13.97 ± 11.34) ml / 100 g and (22.89 ± 11.56) ml / 100 g, respectively. The BV of benign and malignant thyroid nodules were statistically significant (t = 2.211 , P = 0.034 <0.05). There was no significant difference in BF, TTP, PS and MTT (P = 0.234,0.112,0.614,0.709); there was significant difference in MVD between benign and malignant thyroid nodules (t = 7.621, P = 0.000 <0.001). There was a positive correlation between PS and MVD in benign group (r = 0.404, P = 0.05). There was a negative correlation between PS value and MVD in malignant group (r = -0.601, P = 0.039 <0.05) The indicators BF, BV, TTP, MTT and MVD were not related. Conclusion CT perfusion imaging can quantitatively assess the hemodynamics of thyroid nodules and the value of BV in the differential diagnosis of benign and malignant thyroid lesions is the highest among all the perfusion parameters. The CT perfusion parameters of benign and malignant thyroid nodules, such as PS and MVD has a good correlation, the indirect evaluation of tumor angiogenesis and benign and malignant have important value.