The Clinical Application of Pulmonary Tumors in First Pass Phase by Dynamic CT Perfusion

Objective To discuss perfusion features of peripheral/central bronchial carcinomas and unilateral lung metastasis with dynamic CT perfusion.Materials and Methods 92 cases included 48 peripheral bronchial carcinomas,31 central bronchial carcinomas and 13 unilateral lung metastasis tumors were collected.During breath hold,after injection of contrast medium,30 slices scan were performed (1scan/s) at a fixed table position.Density time curves were evaluated from regions of interest of the whole tumor and high enhancing and low enhancing tumor areas.Perfusion (P) and peak enhancement value (EPV) were calculated using the maximum slope method of miles and compared with size,localization (central or peripheral) and histology.Results Perfusion and peak enhancement value of large tumors (diameter 4 cm) was significantly lower than that of smaller ones(diameter≤4 cm).Independent of size,central carcinomas had a significantly(P0.05) lower perfusion (mean 0.39 ml·min-1·ml-1) than that of peripheral ones (mean 0.73 ml·min-1·ml-1),in contrast,peak enhancement of central and peripheral carcinomas was also significantly different; central carcinomas had a significantly (P0.05) lower perfusion and peak enhancement value than that of unilateral lung metastasis tumors (mean 0.76 ml·min-1·ml-1),and peripheral ones did not.There was no significant difference in both parameters between non small cell lung cancers (NSCLC) and small cell lung cancers (SCLC).Conclusion Tumor perfusion and peak enhancement value depend on tumor size and localization,but not on histology,which can be used to evaluate the prognosis of pulmonary tumors.