Department of Radiology, European Institute of Oncology, Milan, Italy.
AJR Am J Roentgenol. 2010 Jul;195(1):149-54. doi: 10.2214/AJR.09.3212.
The purpose of this study was to assess the effects of IV contrast medium and different CT scan delays on volumetric measurements of pulmonary nodule.
Automated volumes of 35 pulmonary nodules were calculated with two dedicated software packages (designated as software A and software B) for each unenhanced and contrast-enhanced CT scan at 30-, 60-, 120-, 180-, and 300-second delays (injection protocol, 2 mL/s and 2 mL/kg). Nodule attenuation was also determined. Differences between unenhanced and contrast-enhanced volumes were analyzed by Wilcoxon's signed rank test. Contrast-enhanced volume ratio was calculated as the ratio between contrast-enhanced and unenhanced nodule volume.
Contrast-enhanced volumes were significantly larger than unenhanced volumes (p < 0.05) for all the timing delays except at 30 seconds for software A, and no significant differences were found among volumes measured with both software programs at different contrast-enhanced delays. Median volume ratios between contrast-enhanced and unenhanced volumes were 1.04-1.07 for software A and 1.04-1.06 for software B, and median volume ratios within different contrast-enhanced delays were 0.99-1.03 for software A and 0.99-1.04 for software B. We did not find any significant association between contrast-enhanced volume ratio and nodule diameter, site, shape, unenhanced density, or contrast-enhanced density ratio (p > 0.05).
We recommend comparing volume of pulmonary nodules obtained from CT examinations only if they are all performed with or without contrast material, whereas nodule volumes obtained by use of enhanced CT performed with different scan delays are comparable.
本研究旨在评估静脉对比剂和不同 CT 扫描延迟对肺结节容积测量的影响。
使用两种专用软件包(分别命名为软件 A 和软件 B)对每个未增强和增强 CT 扫描的 35 个肺结节进行自动容积计算,扫描延迟分别为 30、60、120、180 和 300 秒(注射方案为 2 mL/s 和 2 mL/kg)。还测定了结节的衰减。通过 Wilcoxon 符号秩检验分析未增强和增强体积之间的差异。计算增强后与未增强结节体积的比值作为增强后体积比。
除软件 A 在 30 秒时外,所有时间延迟的增强后体积均明显大于未增强体积(p<0.05),并且在不同增强后延迟时使用两种软件程序测量的体积之间未发现显著差异。软件 A 的增强后与未增强体积的中位数体积比为 1.04-1.07,软件 B 的中位数体积比为 1.04-1.06;软件 A 的不同增强后延迟的中位数体积比为 0.99-1.03,软件 B 的中位数体积比为 0.99-1.04。我们没有发现增强后体积比与结节直径、部位、形状、未增强密度或增强后密度比之间存在任何显著关联(p>0.05)。
我们建议仅在使用或不使用对比剂进行 CT 检查时比较肺结节的体积,如果使用不同扫描延迟进行增强 CT 检查获得的结节体积是可比的。