Diagnostic value of perfusion parameters of 320-row volume CT single and dual-input combination mode of total tumors in solitary pulmonary tumors

FENG Zaihui; LUO Yanfen; YANG Yanhong; ZHANG Yanbin; DUAN Wei; GE Bing

doi:10.19732/j.cnki.2096-6210.2020.05.013

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Diagnostic value of perfusion parameters of 320-row volume CT single and dual-input combination mode of total tumors in solitary pulmonary tumors

更新时间：2025-12-15

- Diagnostic value of perfusion parameters of 320-row volume CT single and dual-input combination mode of total tumors in solitary pulmonary tumors
- Vol. 29, Issue 5, Pages: 500-505(2020)
- 作者机构：
  
  1. 红河州第三人民医院放射影像科,云南,红河,661000
  2. 东芝医疗（中国）临床应用培训部,北京,100000
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2020.05.013
  CLC：
- Published Online：28 October 2020，
  
  Published：28 October 2020
- 稿件说明：
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冯再辉,罗艳芬,杨艳红,等. 320排容积CT单入口、双入口联合模式全瘤灌注参数对肺内孤立性肿瘤的诊断价值[J]. 肿瘤影像学, 2020, 29(5): 500-505 https://doi.

org/10.19732/j.cnki.2096-6210.2020.05.013
冯再辉,罗艳芬,杨艳红,等. 320排容积CT单入口、双入口联合模式全瘤灌注参数对肺内孤立性肿瘤的诊断价值[J]. 肿瘤影像学, 2020, 29(5): 500-505 https://doi. DOI： 10.19732/j.cnki.2096-6210.2020.05.013.

org/10.19732/j.cnki.2096-6210.2020.05.013 DOI：

摘要

目的：

探讨320排容积CT单入口、双入口联合模式下，全瘤灌注参数对肺内孤立性肿瘤良恶性的鉴别诊断价值，并尝试确定诊断界值。

方法：

对红河州第三人民医院2016年9月2017年10月初诊为肺内孤立性肿瘤病变的54例患者进行灌注扫描。所得数据全部由Vital工作站进行后处理，获得双入口模式下的支气管动脉血流量（bronchial artery flow，AF）、肺动脉血流量（pulmonary artery flow，PF），计算肺动脉灌注指数［perfusion index，PI；PI=PF/（AF+PF）］。同时获得单入口模式下的等效血容量（equiv blood volume，E.BV）、血流萃取率（blood flow extraction，FE）、单入口动脉血流量（single-input artery flow，S-AF）。所有数据使用SPSS 19.0软件进行统计学分析。

结果：

① 肺内良恶性病变的AF、PI、E.BV、FE、S-AF差异有统计学意义。② 肺内良恶性病变全瘤灌注参数受试者工作特征（receiver operating characteristic，ROC）曲线下面积（area under curve，AUC）分别为：AF，0.771；E.BV，0.906；FE，0.772；S-AF，0.775；PI，0.889。AUC比较：E.BV＞PI＞S-AF＞FE＞AF。各参数诊断界值：E.BV=5.00 mL/100 mL，灵敏度0.909，特异度0.857；PI=43.24%，灵敏度0.905，特异度0.121；S-AF=69.65 mL/（100 mLmin），灵敏度1.000，特异度0.714；FE=39.85 mL/（100 mLmin），灵敏度0.636，特异度1.000；AF=54.20 mL/（100 mLmin），灵敏度0.879，特异度0.667。③ 多参数联合，结合形态学诊断阳性预测值达到了93.94%，阴性预测值达到了95.24%，诊断效能明显高于单纯形态学诊断及单一灌注参数诊断。

结论：

320排容积CT全瘤灌注参数对肺内孤立性良恶性病变鉴别诊断具有实际应用价值，且有较大帮助。多参数中，以PI、E.BV、FE诊断效能突出。多参数联合中，结合传统形态学诊断，可达到更高诊断符合率。具体各参数诊断界值尚待探索，亟待统一研究标准。

Abstract

Objective:

To investigate the value of total tumor perfusion parameters in the diagnosis of benign and malignant solitary nodes in the lung with 320-row volume CT single and dual-input technique

and to explore the diagnostic threshold.

Methods:

A prospective perfusion scan was performed on the isolated lung lesions in Honghe Prefecture Third Peoples Hospital from Sep. 2016 to Oct. 2017. All data were post-processed by Vital workstations

all obtained under dual input mode (DI-CTP): bronchial artery blood flow (AF)

pulmonary blood flow (PF)

pulmonary perfusion index [PI; PI=PF/(AF+PF)

]

; under single input mode (SI-CTP): equivalent blood volume (E.BV)

blood flow extraction function (FE)

single-input arterial blood flow (S-AF). All data were statistically analyzed using SPSS 19.0 statistical software.

Results:

① There were significant differences in AF

E.BV

FE and S-AF between benign and malignant lesions in the lung. ② The area under curve (AUC) of the receiver operatingcharacteristic (ROC) curve of the whole tumor perfusion parameters of benign and malignant lesions in the lung were: AF

0.771; E.BV

0.906; FE

0.772; S-AF

0.775; PI

0.889

and E.BV＞PI＞S-AF＞FE＞AF. The diagnostic threshold

sensitivity

specificity of E.BV were 5.00 mL/100 mL

0.909

0.857

respectively. The diagnostic threshold

sensitivity and specificity of PI were 43.24%

0.905

0.121

respectively. The diagnostic threshold

sensitivity and specificity of S-AF were 69.65 mL/(100 mLmin)

1.000

0.714

respectively. The diagnostic threshold

sensitivity and specificity of FE were 39.85 mL/(100 mLmin)

0.636

1.000

respectively. The diagnostic threshold

sensitivity and specificity of AF were 54.20 mL/(100 mLmin)

0.879

0.667

respectively. ③ Multiparameter combination

combined with morphological diagnosis positive prediction values reached 93.97%

negative prediction values reached 95.24%

diagnosis efficiency is significantly higher than

simple morphological diagnosis and single parameter diagnosis.

Conclusion:

The 320-volume CT total tumor perfusion parameters have practical application value in the identification of isolated benign and malignant lesions in the lung

and it is of great help. Among the multiple parameters

the diagnostic performance of PI

E.BV and FE is outstanding. Multi-parameter combination

combined with traditional morphological diagnosis

can achieve higher diagnostic compliance rates. The diagnostic boundary value of each parameter has yet to be explored

and it is urgent to unify the research standard.

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