| Objective To investigate the methods of dynamic enhanced multi-siice spiral CT in the evaluation of blood flow patterns of sol i tary pulmonary nodules (SPNs ) with enhancement, efficacy of dynamic multi-si ice spiral computed tomography (MSCT) for providing quantitative information about blood flow patterns of solitary pulmonary nodules (SPNs ). , the correlation of the quantifiable parameters of blood flow pattern derived with dynamic CT in solitary bronchogenic adenocarcinoma (SBA) and the correlation of vascular endothelial growth factor (VEGF)-positive tumor angiogenesis and the quantifiable parameters of blood flow pattern derived with dynamic CT in solitary bronchogenic adenocarcinoma.Materials and Methods 78 patients with solitary pulmonary nodules (SPNs with strong enhancement) ( 4cm)underwent dynamic multi-slice spiral CT (Marconi Mx8000) scan before and after contrast enhancement by injecting contrast material with a rate 4mL/sec. For the 40 patients in protocol one , one scan was obtained every 2 seconds during 15-45 and 75-105 seconds after injection, while for the 38patients in protocol two ,one scan was obtained every 2 seconds during 11-41 and 71 ~ 101 seconds. For all the patients ,one scan was obtained every 30 seconds during 2-9 minutes. The section thickness was 2.5mm for lesions 3cm and 5mm for lesions 3~ 4cm. Standard algorithm was used in the image reconstruction. Precontrast and postcontrast attenuation on every scan was recorded The perfusion ,peak height ,ratio of peak height of the SPN to that of the aorta and mean transit time were calculated. The quanti f iable parameters (Perfusion ,peak height , ratio of peak height of the bronchogenic adenocarcinoma to that of the aorta and mean transit time) of blood flow pattern derived with dynamic CT in solitary bronchogenic adenocarcinoma were compared with microvessel densities (MVDs) and VEGF expression by immunohistochemistryResults The peak height , perfusion, ratio of peak height of the SPN to that of the aorta and mean transit time in malignant solitary pulmonary nodules (SPNs ).were34.85 Hu 10.87, 30.37 ml/min/100g 11. 14, 13.78% 3. 96, 14.19s 6. 19 separately in protocol one , while those in protocol two were 36.62 Hu 10. 75, 30.01 ml/min/100g 8. 10, 14.70 % 4. 71, 13.91 s 4. 82 . No statistically significant differences were found between the peak height(t= 0.673, p=0.503>0.05) , perfusion (t= 0.152, p=0.880>0.05) , ratio of peak height of the SPN to that of the aorta (t= 0.861, p=0.393>0.05) and mean transit time (t= 0.199, p=0.843>0.05) in malignant solitary pulmonary nodules measured in protocol one and those measured in protocol two.All mean transit time in protocol two (36/36) were measured ,but only part of them (25/32) were measured in protocol one . No statistically significant difference in the peak height was found between malignant (35.79 10.76Hu)and active inflammatory (39.76 4.59Hu)( t=1.148 , p=0.255>0.05). SPN-to-aorta ratio ( 14.27% 4.37 ) and perfusion value (30.18ml/min/100g 9. 58) in malignant SPNs were significantly lower than those of active inflammatory ( 18.51% 2.71, 63.44ml/min/100g 43.87 ) (t=2.978 ,p=0.004<0.05, t=5.590 ,p<0.0001). The correlation between the SBA peak height (PHBA,36.78HU 12.02) and the aortic peak height (PHA) was significant (r=0.506,p<0.0001) .No significant correlation was found between the BA-to-A peak height ratio (15.33% 4.55) and the aortic peak height ( r=0.130,p=0.388>0.05 ) as it was between the SBA pur-fusion ( PBA,31.86ml/min/100g 9.74 ) and the aortic peak height (r=0.049,p=0.749>0.05) . The SBA perfusion correlated with the PHBAand the BA-to-A peak height ratio (r=0.394,p=0.007<0.05; r=0.407,p=0.005<0.05) . The PHuA correlated positively with the BA-to-A peak height ratio ( r=0 781,p<0.0001 ) . Mean transit time was 14. 84seconds 5. 52. PB... |
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