| Part One:A study on the optimization of contrast agents dose in lung cancer with 64-detector helicl CT perfusion imaging.Purpose: To discuss the reasonable individual contrast agents dose in lung cancer with CT perfusion imaging.Materials and Methods: Constant dose group and individual dose groups all have 60 patients,who had exanmined CT perfusion imaging, contrast agents dose of Constant dosage group is 50ml and the individual dose groups is 0.5ml/kg.The data obtained at CT perfusion imaging were then transferred to the workstation, Series of perfusion parameters(blood flow,blood volume,mean transmit time,permeability surface)were measured with perfusion software(Perfusion 3),also noted the value of PH and M/A with ROI located on aorta and lesions, Comparing the differences between the different dosage group in perfusion parameter value.Results: Contrast agents doses which individual dose group used obviously lower than the dose group of constant.By one-way analysis of variance,there were significant differences of BF and the value of PH and M/A with ROI located on aorta and lesions(p<0.001) between the different doerage group;meanwhile, there were no significant differences of BV,MTT,PS(p>0.05).Conclusion: Optimizatd the contrast medium injection dose not only reduce the individual contrast agents, but also make the more reasonable comparison with the value of PH between different patients,and the parameter which obtained can truly reflect the perfusion hemodynamic information of lung cancer. CT perfusion imaging with a deconvolution mathematical model in lung cancer,There were more reasonable using individual contrast agents dose method.Part two: Control study between 64-detector helical CT perfusion imaging with histologic in lung cancerPurpose: To investigate the value of 64-detector helical CT perfusion imaging in evaluating different histological types and stages of lung cancer,and predict the rate of lymph node metastasis.Materials and Methods:80 patients who had diagnosed lung cancer were performed CT perfusion imaging, The data obtained at CT perfusion imaging were then transferred to the workstation, Series of perfusion parameters(blood flow,blood volume,mean transmit time,permeability surface)were measured with perfusion software(Perfusion 3),also noted the value of PH and M/A with ROI located on aorta and lesions, and make relevant statistics analysis.Results:There were no significant differences in the value of perfusion parameters between different histological types and stages of lung cancer(p>0.05),yet there were significant differences in the value of BF and MTT between SLCL and NSLCL(p<0.05),The value of M/A,BF and PS of lymph node metastasis positive group was higher than that of negative group(p<0.05).Conclusion: 64-detector helical CT perfusion imaging indirectly reflect the differentiation of lung cancer,then predict the possibility of lymph node metastasis,it can be used as a useful markers to non-invasively judge the biological behavior and the prognosis of lung cancer.Part there: CT perfusion imaging evaluation on correlation of microvascular density(MVD) and Perfusion Parameters with lung cancer and the status of related lymph nodesPurpose: To evaluate the correlation between 64-detector helical CT perfusion parameters and tumor microvessel density(MVD) in lung cancer, meanwhile to assess the clinical application of CT perfusion in predicting the status of lymph nodes in patients with lung cance. Materials and Methods:43 patients who diagnosed by surgery or biopsies and then collect effective specimens were be enrolled to the study and undergone the 64-detector helical CT perfusion imaging,34 lymph nodes had been received simultaneously. The data obtained at CT perfusion imaging were then transferred to the workstation, Series of perfusion parameters(blood flow,blood volume,mean transmit time,permeability surface)were measured with perfusion software(Perfusion 3),also noted the value of PH and M/A with ROI located on aorta,lesions and"target"lymph nodes.The expressions of CD34 in 43 cases were detected by Streptaridin peroxidase(SP) immunohistochemistry staining,and then the MVD counting was performed.Linear regression correlation analysis was conducted to compare MVD with CT perfusion parameters,and comparing the differences between the metastatic and reactive hyperplastic lymph node.Results: MVD of the 43 lung cancer was 55.4±18.2.Differences of MVD among lung cancer histological types were statistically significant(p<0.001),No significant difference was found between tmnor grade with pathologic confirmation(p>0.05),there was significant difference between the metastatic and reactive hyperplastic lymph node(p<0.05). PH,M/A,BF,BV and PS were correlated positively with extend of microvessd density(r=0.474,0.526,0.657,0.801,0.541,respectively,all p<0.05). 34"target"lymph nodes were metastasis in 22 cases and reactive hyperplastic lymph node inflammation in 12 cases at pathology. Differences of BF and PS between the metastatic and reactive hyperplastic lymph node were statistically significant(p<0.05); there were significant correlations between the PHL,L/A,BF,BV of metastatic lymph node and lung cancer(p<0.05).Conclusion: MVD was associated with tumor histological type and metastasis, 64-detector helical CT perfusion could be a valuable technique for evaluating tllinor angiogenesis. CT perfusion imaging can provide useful informafion for evaluating lymph node status. |
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