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目的评估氙气增强双能量CT肺通气成像在肺癌中的应用价值。方法 25例研究对象在第一代双源CT上进行了氙气动态增强双能量CT检查。将研究对象分为正常组(n=4)和肺癌组(n=21),其中肺癌组按有无支气管阻塞分为阻塞(n=16)和非阻塞组(n=5),在动态氙气增强图像上测量氙气浓度,对氙气浓度变化及氙图表现进行分析。定量资料以均数±标准差(x珋±s)表示,平均值比较均采用两独立样本的t检验。结果 4例正常人流入相(80 s)氙图表现为均匀一致强化,两肺氙气浓度差异无统计学意义[右侧(21.3±2.8)%;左侧(22.7±4.1)%,P=0.284]。正常组流入相20～80 s氙气浓度迅速上升,到80 s时达到峰值;流出相80～200 s氙气浓度快速下降,200 s时测得氙气浓度为0%。16例肺癌阻塞支气管患者,均出现不同程度的通气缺损;阻塞肺段流入相(80 s)氙气浓度平均值低于对侧[阻塞侧(6.3±7.5)%;对侧(20.9±3.7)%,P<0.0001]。动态增强扫描阻塞组出现明显氙气流入受限,其中6例可观察到肺阻塞肺段氙气低水平流入伴/不伴流出延迟。非阻塞组5例患者均未出现明显的通气缺损和氙气滞留。结论氙气增强双能量CT可评估正常人和肺癌患者的通气功能,对于肺癌支气管阻塞患者可显示通气缺损并可能提示旁路通气存在。
Objective To assess the value of xenon enhanced dual energy CT pulmonary ventilation imaging in lung cancer. Methods Twenty-five subjects underwent xenon dynamic enhanced dual-energy CT examination on the first generation dual-source CT. The subjects were divided into normal group (n = 4) and lung cancer group (n = 21). Lung cancer group was divided into occlusion (n = 16) and non-occlusion group Enhanced image measurement of xenon concentration, changes in xenon concentration and xenon map performance analysis. Quantitative data with mean ± standard deviation (x 珋 ± s) that the average comparison using two independent samples t test. Results The xenon images of four normal infants entering the phase (80 s) showed uniform enhancement with no significant difference in the xenon concentrations between the two lungs [right (21.3 ± 2.8)%; left (22.7 ± 4.1)%, P = 0.284 ]. In the normal group, the concentration of xenon increased rapidly from 20 to 80 s and peaked at 80 s. The concentration of xenon decreased rapidly from 80 to 200 s in the effluent phase, and the concentration of xenon was 0% at 200 s. Sixteen patients with bronchial obstruction of lung cancer showed different degrees of ventilatory defect. The average xenon concentration in obstructive pulmonary segment inflow phase (80 s) was lower than that of contralateral (6.3 +/- 7.5)%, contralateral (20.9 +/- 3.7)%, , P <0.0001]. In the dynamic contrast-enhanced-scan block group, there was a clear limitation of xenon inflow, of which six cases were observed with low xenon in-pulmonary inflow with / without outflow delay. Non-occlusion group 5 patients showed no obvious ventilation defects and xenon retention. Conclusions Xenon-enhanced dual-energy CT can assess ventilation in both normal and lung cancer patients, and may show ventilatory defects in patients with bronchial obstruction of lung cancer and may indicate the existence of bypass ventilation.