Clinical Study Of CT Perfusion Imaging In Differential Diagnosis And Effect Of Therapy Of Lymph Node Leisions

To study the difference and relativity of CT perfusion value in metastatic lymph node and muscle by MSCT perfusion imaging. To probe into the difference and relativity of CT perfusion value in lymphoma and metastatic lymph node and muscle by MSCT perfusion imaging. And to find out whether differentiation the malignant nodal after therapy was possible by MSCT perfusion imaging. Finally,to analysis the value of CT perfusion imaging in differential diagnosis and effect of therapy of malignant lymph node leisions.The first part:Clinical study of CT perfusion imaging in differential diagnosis of metastatic lymph nodeObjective:To measure and assess CT perfusion value for metastatic lymph node by using MSCT with body perfusion software package.Methods:The MSCT perfusion imaging was performed for metastatic lymph nodes and muscle on a multisection CT scanner(SOMATOM Volume Zoom4 Siemens).4×5mm collimation,120kV,60mA.Contrast injection was done by using 40 ml nonionic contrast agent(300mg I/ml),at a flow rate of 4.0 ml/s with a power injector,and 5 seconds delay,and data acquisition lasted for 40 seconds.The mean MIP,BV,BF and TP were measured and statistically analyzed in patients with metastatic lymphnodes proven by clinic and pathology (n=75)and normal muscle (n=50) on a MV 300 work station using body perfusion software (Siemens) with deconvolution method.Results:The mean BF in normal muscle were 19.98 ±7.52 ml/min / 100ml,The mean BF in metastatic lymph nodes were 51.15 ±18.42 ml/ min/100ml(the mean BF in cervical metastatic lymph nodes were 49.55±16.45ml/min/100ml,the mean BF in mediatinal metastatic lymph nodes were 50.27±20.19ml/min/100ml, the mean BF in peripancreatic metastatic lymph nodes were 53.63±18.82ml/min/100ml,the mean BF among these were not significant),The mean BF in metastatic lymph nodes were significantly higher than that in normal muscle (P<0.001).Conclusion:It is possible to differentiate between metastatic lymph nodes and muscle with perfusion imaging of MSCT and qualitative assessment ofperfusional value was useful in detecting malignancy.The second part:Clinical study of CT perfusion imaging in differential diagnosis of lymphoma and metastatic lymph nodesObjective:To measure and assess CT perfusion value for lymphoma and metastatic lymph nodes by using multisection dynamic CT with body perfusion software package.Methods:The multisection CT perfusion series was performed for metastatic lymph nodes and lymphoma and muscle on a multisection CT scanner(SOMATOM Volume Zoom4 Siemens),4x5mm collimation, 120 kV, 60mA.Contrast injection was done by using 40ml nonionic contrast agent(300mg I/ml),at a flow rate of 4.0 ml/s with a power injector,and 5 seconds delay,and data acquisition lasted for 40 seconds.The mean MIP,BV,BF and TP were measured and statistically analyzed in patients with lymphoma(n=24) and metastatic lymph nodes (n=75)proven by clinic and pathology and normal muscle on a MV 300 work station using body perfusion software (Siemens) with deconvolution method .Results:The mean BF in normal muscle were 19.98 ±7.52 ml/min /100ml, The mean BF in lymphoma was 65.63±20.98ml/min/100ml,The mean BF in metastatic lymph nodes were 51.15±18.42ml/min/100ml.The mean BF in lymphoma and metastatic lymph nodes were significantly higher than it in normal muscle(P<0.001),The mean BF in lymphoma were higher than that in metastatic lymph nodes(P<0.05).Conclusion:It is possible to differentiae among lymphoma andmetastatic lymph nodes and muscle with perfusion imaging of MSCT and qualitative assessment of perfiisional value was useful in detecting malignancy.The third part:Clinical study of CT perfusion imaging in effect of therapy of malignant lymph node leisionsObjective:To find out whether differentiation the malignant node leisions after therapy was possible by using MSCT with body perfusion software package.Methods:The MSCT perfusion imaging was performed for metastatic lymph nodes and lymphoma after therapy on a multisection CT scanner (SOMATOM Volume Zoom4 Siemens),4x5mm collimation,120 kV, 60 mA.Contrast injection was done by using 40ml nonionic contrast agent (300mg I/ml),at a flow rate of 4.0 ml/s with a power injector,and 5 seconds delay,and data acquisition lasted for 40 seconds.The mean MIP,BV,BF and TP were measured and statistically analyzed in patients with metastatic lymph nodes after therapy (n=20)and lymphoma after therapy(n=15) on a MV 300 work station using body perfusion software (Siemens) with deconvolution method .Results:The mean BF in metastatic lymph nodes after therapy were 30.39±14.46ml/min/100ml,The mean BF in lymphoma after therapy were 25.71±12.93ml/min/100ml.The mean BF of malignant lymph nodes after therapy were prominently lower than that before therapy (P<0.001). The mean BF of metastatic lymph nodes after therapy were higher than that in muscle(P<0.005).Conclusionrlt is possible to evaluate the effect of therapy of malignant...