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目的探讨多层螺旋 CT 灌注成像技术定量评价腮腺良、恶性肿瘤的血液动力学特点及其对腮腺良恶性肿瘤的鉴别诊断价值。方法 53例患者共57个病变,其中良性肿瘤35例,恶性肿瘤18例,全部经术后病理证实。术前行 CT 灌注检查。采用 Philips perfusion 功能软件包获取组织的时间密度曲线(time density curve,TDC)及 CT 灌注参数,包括灌注量、增强峰值(PH)、达峰时间(TTP)、血容量(BV)、平均通过时间(MTT)。采用 Wilcoxon 符号秩和检验进行统计学处理。结果腮腺良性肿瘤的 CT 灌注参数的中位数及四分位间距[25% CI 75%(Q_1,Q_2)]分别为:灌注量73.5(18.7,113.3)ml·100g~(-1)·min~(-1)、PH 34.5(17.7,53.1)HU、TTP 20.0(13.6,34.4)s、BV 38.5(29.1,63.3)ml·100 g~(-1)、MTT 7.6(4.5,28.7)s。腮腺恶性肿瘤的 CT 灌注参数分别为:灌注量135.9(101.4,195.2)ml·100 g~(-1)·min~(-1),PH 49.1(32.7,59.4)HU,TTP 12.9(11.3,14.6)s,BV 67.5(52.4,109.5)ml·100 g~(-1),MTT 6.0(5.1,7.6)s。统计结果显示,CT 灌注参数 BF、BV、TTP 的中位数及四分位间距在腮腺良恶性肿瘤之间差异具有统计学意义(P 值均<0.05),而 PH、及 MTT 之间差异无统计学意义(P>0.05);腺淋巴瘤、其他良性肿瘤、恶性肿瘤的 TDC 的差异也有统计学意义(P 值均 <0.05)。结论 CT 灌注扫描技术对腮腺良恶性肿瘤的鉴别诊断具有一定价值。
Objective To investigate the hemodynamic characteristics of benign and malignant parotid gland tumors by multi-slice spiral CT perfusion imaging and to evaluate the differential diagnosis of parotid benign and malignant tumors. Methods A total of 57 patients with pathological changes in 53 patients, including 35 cases of benign tumors, 18 cases of malignant tumors, all confirmed by postoperative pathology. Preoperative CT perfusion examination. Tissue time-density curves (TDC) and CT perfusion parameters were acquired using Philips perfusion software package, including perfusion volume, peak value (PH), time to peak (TTP), volume of blood (BV), mean transit time (MTT). The Wilcoxon signed rank sum test was used for statistical analysis. Results The median and interquartile range [25% CI 75% (Q_1, Q_2)] of CT perfusion parameters in parotid benign tumors were: perfusion 73.5 (18.7,113.3) ml · 100g -1 · min ~ (-1), pH 34.5 (17.7,53.1) HU, TTP 20.0 (13.6,34.4) s, BV 38.5 (29.1,63.3) ml · 100 g -1, MTT 7.6 (4.5,28.7) s. CT perfusion parameters of parotid malignant tumor were 135.9 (101.4,195.2) ml · 100 g -1 · min -1, 49.1 (32.7,59.4) HU, TTP 12.9 (11.3, 14.6 ) s, BV 67.5 (52.4,109.5) ml · 100 g -1, MTT 6.0 (5.1,7.6) s. The statistical results showed that the median of CT perfusion parameters BF, BV, TTP and the interquartile range were statistically different between benign and malignant parotid tumors (P <0.05), while there was no difference between PH and MTT Statistical significance (P> 0.05); The differences of TDC between adenolymphoma, other benign tumors and malignant tumors were also statistically significant (P <0.05). Conclusion CT perfusion scanning technique has certain value in the differential diagnosis of benign and malignant parotid tumors.