Preliminary Research The Diagnosis Value Of MSCT Perfusion Imaging In Lung Neoplasms And The Correlation Of Lung Cancer And Mircrovessel Density

Purpose: Preliminary research the value of multislice helical CT perfusion imaging in distinguish diagnosis benign tumor from malignant ones and to explore the correlation of lung neoplasms and mircrovessel density(MVD). Materials and methods: 86 cases of lung neoplasmas were studied in perfusion imaging. 70malignant tumor. 42 adeuocarcinoma, 25 squamous, 3 small cell lung cancer. 16 benign tumor, 7tuberculomas, 8 inflammatory nodules, 1hamartoma. Perfusion images were transferred into body perfusion-2 software on ADW4.0 workstation to create and analyze perfusion images and parameters including Time-density courves (TDC),Blood Flow (BF),Blood volume (BV), Meant Transit Time (MTT) and Permeability Surface (PS). MVD were measured with. Immunohisto- chemical method in 38 cases of lung cancer. Results: The thoracic aorta was selected as input aorta,The mean BF,BV,MTT,PS in 25 malignant tumor was 33.51±19.76ml/100mg/min, 10.43±5.46ml/100mg,19.22±8.54sec, 44.12±25.69ml/100mg/min, respectively. In 16 benigntumor, perfusion parameters was 28.01±22.70ml/100mg/min, 4.74±3.08ml/100mg, 10.3±12.67sec, 10.23±3.87ml/100mg/min, respectively. The mean PS in malignant tumor and benign tumor was statistically significant( P<0.05 One-Way ANOVA analysis ). The pulmonary trunk was selected as input aorta, The mean BF,BV,MTT,PS in 25 malignant tumor was 33.51±19.76ml/100mg/min, 10.43±5.46ml/100mg, 19.22±8.54sec, 44.12±25.69ml/100mg/min, respectively. In 9 benign tumor perfusion parameters was 28.01±22.70ml/100mg/min, 4.74±3.08ml/100mg, 10.3±12.67sec, 10.23±3.87ml/100mg/min, respectively. The mean BV, MTT and PS in malignant tumor and benign tumor was statistically significant( P<0.05 One-Way ANOVA analysis ). When BV≥5ml/100mg was set as a diagnotic threshold , the sensitivity, specificity, positive predict values and negative predict values were 96%, 78%, 92%, 87.5%, resoestively. When PS≥25ml/100mg/min was set as a diagnotic threshold , the sensitivity, specificity, positive predict values and negative predict values were 68%, 67%, 85%, 42%, resoestively. MVD of cancer was 61.38±10.23 in hot spot field.MVD of benign tumor was 10.23±7.07 in hot spot field. MVD between the two groups showed statistically significant( P<0.05 One-Way ANOVA analysis ). The mean BV of cancer positive correlated with MVD( r=0.752 P<0.01), if the pulmonary trunk was selected as input aorta.Conclusion: MSCT perfusion imaging is helpful with conventional CT in the differentiation of beign lung neplasms from malignant ones. The pulmonary trunk was selected as input aorta, The mean BV, PS in malignant tumor and benign tumor was statistically significant. Cambined BV with PS can help us improve the rate of malignant tumor diagnosis. And the mean BV of cancer positive correlated with MVD.