1、介入放射学杂志2023年2月第32卷第2期J Intervent Radiol 2023,Vol.32,No.2management of postoperative lymphorrhea J.Langenbecks ArchSurg,2021,406:945-969.4 Nadolski GJ,Itkin M.Feasibility of ultrasound-guided intranodallymphangiogram for thoracic duct embolization J.J Vasc IntervRadiol,2012,23:613-616.5 Lv S,Wang Q,Z
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7、a RC,Minocha J.Cerebral embolization ofethiodized oil following intranodal lymphangiographyJ.SeminIntervent Radiol,2015,32:10-13.（收稿日期：2021-12-19）（本文编辑：边佶）临床研究Clinical research 双输入模型CT灌注成像在肺结节经皮穿刺活检中的临床应用郭成伟，颜林军，李长云，李晓燕，张乐，杨卓，蒋博民，赵立威【摘要】目的分析双输入模型 CT 灌注成像（dual-input body CT perfusion imaging，DI-CTP）在
8、肺结节经皮CT穿刺活检中的临床应用价值。方法收集94例接受DI-CTP引导经皮穿刺活检肺结节患者的临床资料，分析DI-CTP引导肺结节穿刺阳性率及病理诊断准确率，比较DI-CTP引导穿刺活检与肺动脉灌注指数（PI）对肺结节的诊断效能。结果94例患者中，良性结节30例，恶性结节（周围型肺癌）64例。DI-CTP引导穿刺活检病理诊断准确率为89.36%（84/94），穿刺活检阳性率为96.80%（91/94）；DI-CTP引导穿刺活检诊断肺结节的敏感度和特异度均高于PI，差异有统计学意义（=5.83、4.02，均P0.01）。结论DI-CTP灌注伪彩图及定量参数分析为肺结节穿刺活检提供了直观影像学
9、依据，提高了肺DOI：10.3969/j.issn.1008-794X.2023.02.013基金项目：国家卫健委医药卫生科技发展研究中心项目（GWJJ2021100304），河北省医学科研计划项目（20221908、20210445）；保定市科技计划项目（2141ZF121）作者单位：071000河北保定陆军第82集团军医院医学影像诊断科（郭成伟、张乐、杨卓），超声科（李长云）；京西医疗区综合内科（颜林军）；解放军总医院第一医学中心肿瘤内科（李晓燕）；保定市第一中医院（蒋博民）；保定市人民医院放射科（赵立威）通信作者：郭成伟E-mail:161介入放射学杂志2023年2月第32卷第2期J I
10、ntervent Radiol 2023,Vol.32,No.2结节穿刺活检阳性率、病理诊断准确性及鉴别诊断效能。【关键词】肺癌；体层摄影术，肺结节；经皮活检术；CT灌注成像中图分类号：R816.41文献标志码：B文章编号:1008-794X（2023）-02-0161-06The clinical application of dual-input body CT perfusion imaging in percutaneous puncture biopsyof pulmonary nodulesGUO Chengwei,YAN Linjun,LI Changyun,LI Xiaoyan
11、,ZHANG Le,YANG Zhuo,JIANG Boming,ZHAO Liwei.Department of Medical Imaging,No.82 Army Hospital,Baoding,HebeiProvince 071000,ChinaCorresponding author:GUO Chengwei,E-mail:【Abstract】ObjectiveTo discuss the clinical application value of dual-input body CT perfusionimaging（DI-CTP）in CT-guided percutaneou
12、s puncture biopsy of pulmonary nodules.MethodsTheclinical data of 94 patients,who received DI-CTP-guided percutaneous puncture biopsy of pulmonarynodules,were retrospectively analyzed.The positive rate of pulmonary nodules and the accuracy rate ofpathological diagnosis were calculated,and the diagno
13、stic efficacy for pulmonary nodules of DI-CTP-guidedbiopsy was compared with that of pulmonary artery perfusion index（PI）.Results Among the 94 patients,benign nodule was seen in 30,and malignant nodules（peripheral lung cancer）was found in 64.InDI-CTP-guided biopsy,the accuracy rate of pathological d
14、iagnosis was 89.36%（84/94）and the positive rateof pulmonary nodules was 96.80%（91/94）.The sensitivity and specificity for diagnosing pulmonary nodulesby DI-CTP-guided puncture biopsy were significantly higher than those by PI,and the differences betweenthe two were statistically significant（both P0.
15、01）.Conclusion The pseudo-color image and quantitativeparameter analysis of DI-CTP perfusion provide a visual imaging basis for the puncture biopsy of pulmonarynodules,which improves the positive rate of pulmonary nodule puncture biopsy,pathological diagnosisaccuracy and differential diagnosis effic
16、acy.【Key words】lung cancer;tomography;pulmonary nodule;percutaneous biopsy;CT perfusion imaging常规影像学检查如CT、PET-CT等对肺结节的鉴别诊断发挥了重要作用，但对于临床精准治疗、辅助化疗、靶向及免疫治疗后的评估仍均需准确的组织病理学检测1-3。CT引导穿刺活检是肺周围性病变常用的获取病理组织的方法，但肺结节多由坏死的肺组织和炎性组织等混杂而成，假阴性率为20%30%4-5。本研究回顾性分析肺结节穿刺活检成功的94例患者的临床资料，探讨双输入模型 CT灌 注 成 像（dual-input body CT perfusion imaging，DI-CTP）在经皮CT引导穿刺活检中的应用价值。1材料与方法1.1病例资料选择2016年6月至2019年10月陆军第82集团军医院经皮CT肺部穿刺活检成功的患者94例，男53例，女41例，年龄4573岁。其中恶性结节（周围型肺癌）64例，良性结节30例。纳入标准：纤维支气管镜检查及痰细胞筛查阴性患者；术前CT图像评估显示有可选择的穿刺进针路径；术前凝