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目的:探讨运用320排CT双入口灌注成像技术,评估结核病灶灌注参数值对肺结核化疗近期效果的预测作用。方法:将30例肺结核按形态学分为结核球、空洞型病灶和浸润型病灶三组。化疗前7 d内CT检查与化疗后30 d的CT平扫结果进行比较,根据标准评定疗效分成缓解组与未缓解组。化疗前7 d内及化疗后14 d行2次CT灌注扫描,比较化疗前、化疗后早期CT灌注参数的变化与化疗疗效的关系。结果:30例患者中缓解组20例,非缓解组10例;化疗前与化疗后早期病灶大小进行比较,均未见明显变化。化疗前及化疗后早期CT各灌注参数在两组中均有变化。缓解组结核的治疗前PF、BF值高于未缓解组,其差异有统计学意义(t=6.23,t=7.61;P<0.001),缓解组中结核病灶灌注值治疗前后有显著性差异,灌注值有所下降,未缓解组中治疗前后结核病灶灌注值升高,BF值治疗前14.06±4.09,治疗后升至36.68±4.41,其差异显著。PF值虽轻度升高,但无显著性差异。结论:320排双入口灌注技术对肺结核化疗后早期疗效的评估有一定的价值。肺结核治疗后的灌注值变化与近期疗效相关,BF值升高提示结核病灶进展,预后较差。
Objective: To evaluate the predictive value of tuberculosis perfusion parameters on the short-term effect of chemotherapy for pulmonary tuberculosis by using 320-row CT dual-port perfusion imaging. Methods: Thirty cases of tuberculosis were divided into three groups: tuberculoma, cavity type and infiltrative type. The CT scan within 7 days before chemotherapy was compared with the CT scan 30 days after chemotherapy. According to the standard, the curative effect was divided into remission group and non-remission group. The CT perfusion scan was performed within 7 days before chemotherapy and 14 days after chemotherapy. The relationship between CT perfusion parameters and the effect of chemotherapy before and after chemotherapy was compared. Results: Among 30 patients, 20 patients in the remission group and 10 patients in the non-remission group showed no significant changes in the size of the lesions before and after chemotherapy. Before chemotherapy and chemotherapy after CT perfusion parameters in both groups have changed. The difference was statistically significant (P = 0.001) between the two groups (t = 6.23, t = 7.61; P <0.001), and there was a significant difference between the two groups The perfusion value decreased, and the perfusion value of tuberculosis increased before and after treatment in the non-relieving group. The value of BF before treatment was 14.06 ± 4.09, and after treatment, it increased to 36.68 ± 4.41, with significant difference. Although the PF value slightly increased, but no significant difference. CONCLUSION: The 320-row double-entry perfusion technique has some value in the assessment of early curative effect after chemotherapy of pulmonary tuberculosis. The change of perfusion value after tuberculosis treatment is related to the recent curative effect. The increase of BF value indicates the progress of tuberculosis and the prognosis is poor.