CT灌注成像(CT perfusion imaging)是CT功能成像中重要的技术方法之一，它可从组织细胞水平和微循环水平来揭示人体组织器官的正常生理及病理解剖和病理生理的改变，因此在人体脏器功能的评价、脑梗死的早期诊断和脑肿瘤的诊断与鉴别诊断以及疗效评价等方面均可提供更有价值的信息。90年代以来CT灌注成像技术发展十分迅速，预示着CT成像技术不但可以清晰直观地显示组织器官和病变组织的解剖与病理解剖形态学的信息，而且在未来疾病的功能成像诊断中将发挥重要的作用。

Objective: To investigate the clinical diagnostic value of peripheral lung cancer using multi-slice CT (MSCT) perfu-sion imaging and the relationship with microvessel density (MVD). Methods: 38 patients with pulmonary masses proved by pathology including 25 cases of peripheral lung cancer and 13 cases of benign masses were studied prospectively with GE Lightspeed Qx/I plus 16-slice helical CT perfusion imaging, and 25 patients with lung cancer were comparative studied with its MVD calculated using LSAB. With the CT perfusion 2-body tumor software, the parameters of CT perfusion including blood value (BV), blood flow (BF), mean transit time (MTT) and permeability surface (PS) were analyzed. Results: The four param-eter values in lung cancer were all higher than that in pulmonary benign masses, and there were significant differences among BV, MTT and PS (P<0.05), especially in BV (P<0.01). The MVD value of lung cancer was higher than that of pulmonary benign masses (P<0.05), and the MVD of adenocarcinoma was higher than that of squamous cell carcinoma (P<0.05). In 25 cases with lung cancer, there was positive correlation only between BV and MVD value (r=0.852, P<0.01). Conclusion: It is helpful to diagnose the peripheral lung cancer with MSCT perfusion imaging and to differentiate from pulmonary benign masses, its bases are MVD pathologically.

目的：探讨多层螺旋CT(MSCT)灌注成像技术诊断肺癌的临床价及其与肿瘤微血管密度(MVD)的相关性。方法：利用l6层MSCT灌注成像技术前瞻性研究38例经手术病理证实的肺肿瘤(周围型肺癌25例，肺良性肿块l3例)，并与25例肺癌的免疫组化法 MVD进行相关性研究。采用 Perfusion 2体部肿瘤灌注软件包分析以下灌注参数：血液流速(BF)、血 流量(BV)、平均通过时间(MTT)和表面通透性(PS)。结果：肺癌各项CT灌注参数值均高于肺良性肿块，其中MTT和PS值在两组之间差异有显著性意义(P<0．05)，BV值差异有极显著性意义(P<0.01)；肺癌的MVD明显高于肺良性肿块 (P<0.05)，肺腺癌MVD高于肺鳞癌(P<0.05)；肺癌仅BV值与其MVD呈正相关性 (r=0.852，P<0.01)。结论：MSCT灌注成像有助于周围型肺癌的诊断及与良性肿瘤的鉴别诊断，其病理基础与肿瘤微血管密度有关。

目的 探讨多层螺旋CT( 简称MSCT)灌注成像在脑肿瘤中的临床应用价值。方法 24例脑肿瘤行MSCT（GE Lightspeed Plus）灌注成像扫描，其中脑胶质瘤3例，脑膜瘤6例，脑转移瘤9例，垂体瘤4例，脑胶质瘤 复发2例。先平扫确定肿瘤中心层面， 然后以3. 5 ml／s速率静脉团注非离子造影剂 50 ml，采用CT电影扫描技术对肿瘤中心层面进行四层同层灌注扫描，层厚1 0 mm／2 i，扫描延迟时间5S，数据采集45S。应用Perfusion软件进行灌注成像分析。结果 脑肿瘤的血流量(CBF)值均显著增加，胶质瘤≈脑膜瘤> 转移瘤>垂体瘤；脑血容量(CBV) 值稍 有增加，胶质瘤≈脑膜瘤>转移瘤(垂体瘤无增加) ；平均通过时间( MTT)在转移瘤有明显延长； 脑表面通透性(PS)值均显著增加，垂体瘤>脑膜 瘤>胶 质瘤≈转移瘤。复发胶质瘤的CBF值可达1 1 0 ml／( 1 0 0 g·mi n) 左右；PS图有助于肿瘤范围的准确界定和发现小病灶。结论 MSCT灌注成像在显示脑肿瘤血流灌注的特点、在肿瘤范围的准确界定以及在肿瘤术后复发的诊断中均具有潜在重要的临床价值。

目的：进一步探讨MRI技术在肺癌与肺良性肿物诊断中的价值。材料与方法：收集周围型肺癌30例（腺癌17例，鳞癌12例，腺鳞癌l 例)；肺良性肿物12例（结核球8例，错构瘤2例，炎性假瘤2例)。均行常规MRI扫描（GE Signa 1.5T)，其中8例行静脉注射Gd-DTPA 增强扫描。结果：周围型肺腺癌MRI信号表现为，T1WI呈略低或等信号，T2WI多呈高→略高信号(52.9%)；鳞癌T 1WI呈等信号， T2WI呈略高信号；冠状面图像可清晰显示肺上沟癌侵及胸膜顶情况，也可直观显示纵隔型肺癌的范固和侵及纵隔大血管情况；3例肺腺癌增强扫描呈完全强化模；8例肺结核球T1WI呈略低或等信号，T2WI大多呈高、等、低不均匀混杂信号，卫星灶多见，3例增强者呈薄壁均匀环行强化；2例错构瘤及2例炎性假瘤均无特征性MRI表现。结论：MRI对周围型肺癌定性诊断价值有限，但对肺上沟癌和纵隔型肺癌范围的确定及定量诊断很有价值；结合增强扫描可对结核球做出正确诊断。