【摘要】 目的 探讨孤立性肺结节(SPN)螺旋CT动态增强成像与血管生成的关系。方法 对48例SPN患者行多层螺旋CT动态增强扫描,记录净强化值(PH)、结节-主动脉的净强化比值(CER)、时间-密度曲线(TDC)及强化方式(EP)。采用免疫组化测定微血管密度(MVD)并标记血管内皮生长因子(VEGF)。结果 恶性结节和炎性结节较良性结节有更高的PH值、CER值(χ~2=12.76、21.00,P值均<0.001);而恶性结节与炎性结节的PH值、CER值差异均无统计学意义(P>0.05)。VEGF阳性表达28例,MVD计数恶性结节明显高于良性结节和炎性结节(F=110.08,P值均<0.001)。CT动态扫描参数PH值、CER值与恶性、良性和炎性结节的MVD呈正相关性。结论 CT动态增强对SPN的良、恶性具有较高的鉴别诊断价值;其动态增强的特点与SPN的微血管密度和VEGF表达有良好的相关性。更多还原

【Abstract】 Objective To investigate the correlation between 16-slice spiral CT dynamic enhanced imaging features and tumor microvascular density(MVD) and vascular endothelial growth factor(VEGF) in solitary pulmonary nodules(SPN).Methods 48 patients with SPN underwent multi-slice target dynamic contrast-enhanced CT.The quantitative parameters(peak attenuation,ratio of peak attenuation of the SPN to that of the aorta,time-density curve(TDC))of blood flow pattern were recorded and compared with the results of MVD and VEGF expression by using immunohistochemistry.Results Peak attenuation and SPN-to-aorta ratios of malignant and inflammatory SPN were significantly higher than that of benign(χ~2=12.76,21.00,P<0.001);No statistically significant differences in the peak attenuation and SPN-to-aorta ratio were found between malignant and inflammatory SPN(P>0.05).The VEGF positive expression was found in 26 malignant and 2 benign SPN.The average value of MVD in malignant SPN was higher than that of benign and inflammatory SPN(F=110.08,P<0.001).There were statistically significant correlations between CT dynamic contrast enhanced parameters and MVD,respectively.Conclusion Dynamic contrast-enhanced CT can improve the diagnostic accuracy of SPN.There is statistically significant correlation between CT dynamic contrast-enhanced parameters and MVD.更多还原