The Clinical Study Of Dual- Phase Scan For Pulmonary And Bronchial Artery With 64-detector Spiral CT

Part one. The Clinical study of dual- phase scan technique for pulmonary and bronchial artery with 64-detector spiral CTObject: To establish dual-phase enhanced scanning method preliminary for clinical application study of pulmonary and bronchial artery by comparing 64-detector CT screening program of four groups.Materials and Methods: 134 patients underwent routine enhanced chest CT were divided into A, B, C, D four groups. Group A, Group B and Group C use empirical delay method: a fixed 14 s was used in PA, fixed time in BA phase were 20 s, 22 s and 24s; D group used bolus tracking method. To place ROI in the pulmonary trunk,and set up threshold 100 HU, and fix 7s delay, time of scan in BA was 8s- scanning time of PA phase. To measure the CT enhancement values on the superior vena cava, pulmonary trunk, left atrium and ascending aorta, descending aorta to on PA and BA phase. Use ANOVA analysis on target vessel enhancement values of the dual-phase, the CT enhancement value |PA-DA| on the same phase, CT enhancement values|PA-BA| of the same target vessel to comparison the vessels values ’difference between each groups on dual-phase.Results: ① On PA phase,the pulmonary trunk CT enhancement value difference between the groups was not statistically significant(P>0.05), the mean was 435.3HU; Difference of the descending aorta enhancement CT value was statistically significant between the groups(P<0.05).There was statistically significant between group A and group D(P<0.05), group B and group D(P<0.05), group C and group D(P<0.05) with pairwise comparison. ?The CT enhancement value|PA-DA| was no statistically significant between the groups(P>0.05), the mean was 235.3HU; ?Difference of the the pulmonary trunk CT enhancement value between PA and BA phase was no statistically significant(P>0.05), the mean was 282HU; Difference of the the descending aorta CT enhancement value between PA and BA phase was no statistically significant(P>0.05), the mean was 130.5HU; ④The artifacts of the superior vena cava was obvious on PA phase, and the vena cava artifacts disappeared on the BA phaseConclusion: Chest double arterial phase enhanced scaning made the CT enhancement value of PA and DA, the difference brtween PA and BA on dual-phase significantly enhance, and it can be chosen as a method to diagnosis the source of the blood supply of pulmonary disease.The artifacts of vena cava on PA phase eliminated completely on the BA phase.Part Two. The preliminary Clinical study of dual- phase scan for pulmonary and bronchial artery with 64-detector spiral CTObject: To assess the value of 64-detector CT for pulmonary artery(PA) and bronchial artery(BA) phase enhanced scan in the diagnosis of lung disease.Materials and Methods: 31 patients underwent 64-detector CT chest double arterial phase enhanced scan.28 cases were diagnosed by surgical resection, transthoracic needle biopsy or transbronchial biopsy to obtain histological or cytological. Three cases of acute inflammation was significantly absorbed after antibiotic treatment, and diagnosed by clinical follow-up. The cases divided into malignant and inflammation group. Malignant group had 18 cases, including 7 cases of squamous cell carcinoma, 8 cases of adenocarcinoma, small cell lung cancer,carcinosarcoma, adenosquamous carcinoma 1 case; 13 cases of inflammation group, including organized pneumonia cases, tuberculosis 4cases, inflammatory pseudotumor 1case, three cases of acute inflammation. Unenhanced, PA and BA phase of CT values were measured of lesions, and calculated the PA phase net value and BA phase absolute net. Use this two values as indicators to evaluate PA and BA phase blood supply. Use the CT enhancement net value to assess the strengthening of the blood supply of lesion. net ≤20 means low blood supply; 21-30 means moderate blood supply; > 30 means high blood supply.Results: ①.The PA phase of CT enhacement net value was no significant difference between Malignant lesions and inflammation group(P> 0.05), BA absolute enhacement net value difference between the groups was statistically significant(P <0.05). ②.6 squamous cell carcinoma cases showed low blood supply on PA phase,moderate / high blood supply on BA phase performance. ③.7 cases of adenocarcinoma showed PA of low / moderate blood supply, moderate / high blood supply on BA phase performance. ④.Tuberculosis showed PA phase of low blood supply(4 cases), BA phase of low blood supply(three cases).⑤.3 cases of acute inflammation were PA phase high blood supply, BA phase performance of low blood supply. ⑥ Organizing pneumonia in 5 cases, two patients showed PA phase of low /moderate blood supply, BA high blood supply; 3 cases showed PA phase of high / moderate blood supply, BA phase of low blood supply.Conclusion: Chest double arterial phase scan is helpful for differential diagnosis of inflammation and malignant lesions in the lungs.