Ye Xiao-Dan, Ye Jian-Ding, Yuan Zheng, Dong Sheng, Xiao Xiang-Sheng
Department of Radiology, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030.
Oncol Lett. 2012 Mar;3(3):672-676. doi: 10.3892/ol.2011.520. Epub 2011 Dec 12.
The purpose of this study was to determine whether computed tomographic scans and attenuation measurements on contrast material-enhanced and non-enhanced computed tomographic scans could be used to characterize solitary pulmonary nodules and, in particular, to characterize these lesions using washout characteristics on contrast-enhanced computed tomography. A total of 63 patients (38 males, 25 females; age range, 21-80 years; mean age, 58±13.2 years) with pulmonary nodules revealed on contrast-enhanced computed tomography underwent 20-min delayed enhanced scans. The mean diameter of the pulmonary nodules was 1.8±0.6 cm (range, 0.8-2.9). Region-of-interest measurements were obtained at non-enhanced, dynamic enhanced and delayed enhanced computed tomography and were used to calculate a relative percentage washout as follows: 1 - (Hounsfield unit measurement on delayed image/Hounsfield unit measurement on dynamic image) × 100%. There was a mean relative washout of 33% on the delayed computed tomographic scans (range, 12-46) in benign solitary pulmonary nodules; and a mean relative washout of 7% (range, -36-51) in malignant solitary pulmonary nodules (Mann-Whitney U test, p<0.001). Results of the receiver operating curve analysis revealed that a threshold relative washout of 14.5% had 74.3% sensitivity and 92.9% specificity for identifying malignant nodules. Calculation of the relative percentage washout on dynamic and delayed enhanced computed tomographic scans may lead to a highly specific test for solitary pulmonary nodule characterization and reduce the need for, and possibly obviate, follow-up imaging or biopsy.
本研究的目的是确定在对比剂增强和非增强计算机断层扫描上的计算机断层扫描及衰减测量是否可用于对孤立性肺结节进行特征性描述，特别是利用对比增强计算机断层扫描上的洗脱特征对这些病变进行特征性描述。共有63例在对比增强计算机断层扫描上发现有肺结节的患者（38例男性，25例女性；年龄范围21 - 80岁；平均年龄58±13.2岁）接受了20分钟延迟增强扫描。肺结节的平均直径为1.8±0.6 cm（范围0.8 - 2.9）。在非增强、动态增强和延迟增强计算机断层扫描上进行感兴趣区测量，并用于计算相对洗脱百分比，如下：1 - （延迟图像上的亨氏单位测量值/动态图像上的亨氏单位测量值）×100%。良性孤立性肺结节在延迟计算机断层扫描上的平均相对洗脱率为33%（范围12 - 46）；恶性孤立性肺结节的平均相对洗脱率为7%（范围 - 36 - 51）（曼-惠特尼U检验，p<0.001）。受试者工作曲线分析结果显示，相对洗脱阈值为14.5%时，识别恶性结节的敏感性为74.3%，特异性为92.9%。计算动态和延迟增强计算机断层扫描上的相对洗脱百分比可能会得出一种对孤立性肺结节特征性描述具有高度特异性的检测方法，并减少随访成像或活检的需求，甚至可能避免这种需求。
