Correlative Study Of Dual-source CT Perfusion Imaging And Regional Lymph Node Metastasis Of Non-small Cell Lung Cancer

Objective: To study the correlation of dual-source CT perfusion imaging and regional lymph node metastasis of non-small cell lung cancer(NSCLC)and to explore the value of the dual-source CT perfusion imaging in the diagnosis of NSCLC regional lymph node metastasis.Methods: 42 patients with pulmonary mass which found by routine CT scanning,then underwent CT perfusion imaging successfully pre-operation with the dual-source CT and finally diagnosed NSCLC by pathology in Affiliated Hospital of Zunyi Medical College from January 2015 to September 2016 were collected.The cases include 28 males and 14 females,aged from 25 to 74 years,with a mean age of 53.64 years.All perfusion data were transmitted to workstation(Siemens Syngo Multimodality workplace),then analyzed with perfusion software(VPCT body)to obtain time-density curve and perfusion parameters,blood flow(BF),blood volume(BV),mean transit time(MTT),permeability(PMB)as well as their corresponding perfusion pseudo-color images.The PV 2-Step method immunohistochemical detection system was used to stain the 42 cases specimens.Then microvessel density(MVD),luminal vascular number(LVN),luminal vascular area(LVA)and luminal vascular perimeter(LVP)were counted.The cases were divided into two groups that patients with lymph node metastasis group(20 cases)and without lymph node metastasis group(22 cases)according to their pathological results to observe the difference of dual-source CT perfusion parameters,MVD and luminal vascular parameters between them.Correlation analysis was used to study the relationship of dual-source CT perfusion parameters and microvascular parameters of NSCLC.Then ROC curve was used to analyze the diagnostic effectiveness of dual-source CT perfusion parameters in the diagnosis of NSCLC with regional lymph node metastasis.Results: Patients with lymph node metastasis presented significantly higher LVA,BF and lower MTT,PMB than patients without lymph node metastasis.There are no significant difference in BV,LVN,LVP and MVD.Correlation analysis showed that BF has positivelycorrelated with LVA and LVP,while BV,MTT and PMB there were no correlation with LVN,LVA and LVP.All dual-source CT perfusion parameters were correlated negatively with the MVD.According to the ROC curve analysis,BF has a certain value in judging whether NSCLC accompanied with regional lymph node metastasis,and when regard BF >87.23 ml / 100ml/min as a cutoff point to predict lymph node metastasis,the diagnosis coincidence rate is 71.4%.Conclusion: BF and LVA have close relationship with regional lymph node metastasis and BF can be used as one of the reference indexes in predicting NSCLC regional lymph node metastasis before operation.