Clinical Study Of Solitary Pulmonary Nodules With Single-location Enhanced Dynamic CT

Aim To investigate the value of the time-intensity curves and the dynamic enhancement patterns in the diagnosis or differentiation of SPNs and to measure the relationship between the CT enhancement and the angiogenesis of peripheral lung cancer.Materials and Methods1 .PatientsOne hundred sixteen adult patients with SPNs (diameter<4cm) studied, which included 47 adenocarcinoma, 30 squamous cell carcinoma, 7bronchioloalveolar carcinoma, 17 inflammatory nodules, 13 tuberculomas and 3 benign neoplasms. All nodules had not cavitation or calcification. The diagnoses of 7 inflammatory nodules were based on resolution of the lesion on serial chest radiographs after antibiotic treatment, the other SPNs were confirmed by means of surgery, CT-guided transthoracic needle aspiration biopsy.2.Methods of CT scanningSerial single-location dynamic scans were obtained with use of a SOTATOM PLUS S scanner. The section thickness was 5mm,the best section was selected before injection of nonionic contrast material, hen nonionic contrast material l.5m1/kg were injected via the antecubital vein in the rate of 2ml/sec, two serial scannings were obtained began at 6s and 2mm, for the first series the scanning internal was 3 seconds, for the second series, the scanning internal was 7 seconds.3 Methods of studying figureThe CT numbers of lesion on plain CT and on contrasted CT at serial phases were recorded, on which the time-intensity was produced. The type of the dynamic enhancement patterns of SPNs was determined without knowledge of the surgical or pathological results.4.Pathologic studyThe CT numbers of 32 peripheral lung cancers on plain CT and on4contrasted CT at pulmonary artery phase and aortic artery phase of first-pass circulation were recorded. After the surgery, 32 surgical specimens were sectioned transversely in the same plane as a CT scanning and then stained with hematoxylin-eosin. MVD were measured. The results were analyzed and compared with CT enhancement.5.Statistical analysesAll statistical analyses were performed with statistical software SPSS and the level of significance was considered to be PO.05). The enhancement patterns of tuberculomas were statistically significant compared with lung cancers and inflammatory nodules (P3cm,most of them showed inhomogeneous or peripheral enhancement with an irregular inner edge. Most of tuberculomas showed no enhancement or perpheral enhancement with a regular inner edge. Most of inflammatory nodules showed inhomogeneous enhancement.3.Compared with the CT numbers of lung cancers on plain CT, the CT numbers at pulmonary artery phase of first-pass circulation after the administration of contrast media showed no statistical significance, but the CT numbers at various5aortic artery phase ~shQwedo s~t t~c~l isigtjific~jqe. It was found that the enhancement of the lung cancer correlated well with the microvessel density.DiscussionI Enhancement of nodule is an indication of malignancy or inflammation. The types of time-attenuation c...