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目的 研究周围型肺癌及良性结节CT增强与微血管结构 (包括微血管密度和毛细血管基底膜 )的关系 ,探讨肺内孤立结节 (SPN)CT强化的基础。方法 应用MarconiMX 80 0 0或SiemensPlusS螺旋CT机对 3cm以下的 3 8例肺癌、5例错构瘤、10例活动性炎性结节进行动态增强 ,绘制时间 密度曲线。以ABC法进行免疫组织化学染色 ,标记微血管和微血管基底膜 ,计算微血管密度 (MVD)。结果 肺癌的CT强化值明显高于错构瘤 [( 4 9.0 5± 16.0 8)HUvs ( 8.98± 4.5 6)HU ,t =7.48,P <0 .0 5 ) ] ,与活动性炎性结节无显著性差异 [( 4 9.0 5± 16.0 8)HUvs ( 4 9.5 9± 2 1.3 0 )HU ,t =0 .76,P >0 .0 5 ) ] ;活动性炎性结节与错构瘤之间也有显著性差异 (t=8.3 5 ,P <0 .0 5 )。活动性炎性结节时间密度曲线的上升快且略高于肺癌 ,两者达到峰值后交叉形成一平台 ;错构瘤仅有轻微上升 ,曲线平直。周围型肺癌MVD为 48.45± 10 .0 9,活动性炎性结节49.60± 19.94,两者无显著性差异 (t=-0 .2 6,P =0 .799) ,但均明显高于错构瘤 ( 8.70± 7.3 0 ) (t =11.64 ,P<0 .0 0 1;t=6.0 9,P <0 .0 0 1)。结节CT强化值与MVD呈正相关 (r =0 .80 5 1,P <0 .0 0 1)。以强化值 3 0HU为界将 5 3例结节分成两组 ,两组基底膜完整性无显著性差异 ( χ2
Objective To study the relationship between peripheral lung cancer (CT) and benign nodules (CT) enhancement and microvascular structure (including microvessel density and capillary basement membrane), and to explore the basis of CT enhancement in isolated pulmonary nodules (SPN). Methods 38 cases of lung cancer, 5 cases of hamartoma and 10 cases of active inflammatory nodules under 3cm were dynamically enhanced with MarconiMX 80 0 0 or SiemensPlusS spiral CT machine, and the time density curve was drawn. ABC immunohistochemical staining, microvessel and microvascular basement membrane labeling, calculation of microvessel density (MVD). Results The CT value of lung cancer was significantly higher than that of hamartoma [(4 9.0 5 ± 16.0 8) HU vs (8.98 ± 4.5 6) HU, t = 7.48, P 0.05) (4 9.0 5 ± 16.0 8) HUvs (4 9.5 9 ± 2 1.3 0) HU, t = 0.76, P> 0.05)]. There was no significant difference between active inflammatory nodules and hamartoma There was also a significant difference (t = 8.35, P <0.05). Active inflammatory nodules time-density curve increased slightly faster and slightly higher than lung cancer, the two reached a peak after a cross-platform; hamartoma only slightly increased, the curve straight. Peripheral lung cancer MVD was 48.45 ± 10. 09, active inflammatory nodules 49.60 ± 19.94, no significant difference between the two (t = -0.26, P = 0. .799), but were significantly higher than the wrong Tumor (8.70 ± 7.3 0) (t = 11.64, P <0.001; t = 6.09, P <0.001). Nodular CT enhancement values were positively correlated with MVD (r = 0.8051, P <0.001). Fifty-three nodules were divided into two groups based on the intensified value of 30HU, with no significant difference in the integrity of the basement membrane between the two groups (χ2