目的探究双源CT灌注成像对肺 癌放、化疗疗效的评价及其与肿瘤血管生 成的相关性。方法 选择2015年7月至2017 年9月于我院进行放化疗治疗的64例肺癌 患者作为研究对象。在其放、化疗治疗前 后行双源CT灌注成像扫描，比较治疗有效 及无效患者治疗前后血流量(BF)、血容 量(BV)，对比剂的平均通过时间(MTT)、 峰值时间(TTP)及表面通透性(PS)等灌注 参数的差异；术后取患者病变组织行病理 学检查及免疫组化染色，进行微血管密度 (MVD)计数及血管内皮生长因子(VEGF)表 达情况测定，统计分析灌注参数与MVD、 VEGF的相关性。结果 治疗前有效组灌注 参数BF、BV值显著高于无效组(P<0.05)； 治疗后有效组BF、BV值显著低于治疗前 (P<0.05)，而无效组治疗前后灌注参数无 显著性差异(P>0.05)；MDV与BF、BV呈显 著性正相关(P<0.05)；与TTP呈显著性负 相关(P<0.05)；VEGF与BF、BV、PS呈显著 性正相关(P<0.05)，与TTP呈显著性负相 关(P<0.05)。结论 双源CT灌注成像参数 有助于预测肺癌患者放、化疗治疗效果， 对于评价肺癌血管生成也有一定的价值。

Objective To evaluate the curative effect of chemoradiotherapy for lung cancer by dual-source CT perfusion imaging and its correlation with tumor angiogenesis. Methods A total of 64 patients with lung cancer treated with chemoradiotherapy in the hospital from July 2015 to September 2017 were selected as the subjects. The dual-source CT perfusion imaging scanning was performed before and after chemoradiotherapy. The blood flow (BF), blood volume (BV), perfusion parameters such as mean transit time (MTT) of contrast agent, time to peak (TTP) and permeability surface (PS) were compared between the effective group and the ineffective group before and after treatment. The diseased tissues of patients were collected after operation for pathological examination and immunohistochemical staining. The microvessel density (MVD) was measured and the expression of vascular endothelial growth factor (VEGF) was determined. The correlation between MVD and VEGF were statistically analyzed. Results Before treatment, the BF and BV values of the effective group were significantly higher than those of the ineffective group (P<0.05).After treatment, the values of effective group were significantly lower than those before treatment (P<0.05), but there was no significant difference of perfusion parameters in the ineffective groups before and after treatment (P>0.05). MDV was significantly positively correlated with BF and BV (P<0.05), and negatively correlated with TTP (P<0.05). VEGF was significantly positively correlated with BF, BV and PS (P<0.05), and negatively correlated with BV. Conclusion The parameters of dual-source CT perfusion imaging were conductive to predicting the curative effect of chemoradiotherapy for lung cancer, and they were of certain value in evaluating angiogenesis of lung cancer.