Iemsawatdikul Kriengkrai, Wonglaksanapimon Suwimon, Mingkwansook Varalee, Lornimitdee Wimonrat
Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University Bangkok, Thailand.
J Med Assoc Thai. 2013 Mar;96(3):334-9.
Most of the metastatic lung lesions are relatively high contrast in comparison to the lung background and easily detected in non-contrast enhancement chest computed tomography alone (NECCT). Pediatric patients may get benefit from its minimal radiation dose and lack of adverse reaction from iodinated contrast agent.
To compare effectiveness of non-contrast enhancement chest computed tomography (NECCT) in detecting thoracic metastasis with full protocol chest computed tomography (FPCCT) (chest computed tomography with and without contrast) in non-hematologic extrathoracic malignancy in children.
Both NECCT and FPCCT were evaluated in 50 pediatric patients with non-hematologic extrathoracic malignancy retrospectively. Lung nodules, ground glass opacities, interlobular septal thickening, pleural effusion, pleural thickening, pericardial effusion, endobronchial lesion, and intravascular metastasis were evaluated separately on each CT protocol by two radiologists.
Thirty boys and 20 girls were included in the present study (mean age = 10 years and 3 months). The lesions include nodule (333 detected by NECCT (median = 3), 336 detected by CECCT (median = 3)), ground glass opacity (12 detected by NECCT (median = 0), 15 detected by CECCT (median = 0)), interlobular septal thickening (12 detected by NECCT (median = 0), 11 detected by CECCT (median = 0)). There was 100 percent match of calcified nodules (n = 36), pleural effusion (n = 1), pleural thickening (n = 3), intravascular thrombus (n = 2), and mediastinal lymph node (n = 1) between NECCT and FPCCT studies. There was no statistically significant different in capability of demonstrating all lesions between NECCT and FPCCT. Most of the discrepancies between NECCT and FPCCT were from motion artifact, inadequate inspiration, and radiologist's opinion rather than effect of contrast agent administration itself
NECCT is as effective as FPCCT in evaluation of pulmonary metastasis in non-hematologic extrathoracic malignancies. For evaluation of lung metastases in this population, NECCT alone is sufficient.
与肺实质相比，大多数肺转移瘤具有较高的对比度，仅通过非增强胸部计算机断层扫描（NECCT）即可轻松检测到。儿科患者可能受益于其最低的辐射剂量以及碘化造影剂无不良反应。
比较非增强胸部计算机断层扫描（NECCT）与全方案胸部计算机断层扫描（FPCCT）（增强和非增强胸部计算机断层扫描）在检测儿童非血液系统胸外恶性肿瘤胸部转移方面的有效性。
对50例患有非血液系统胸外恶性肿瘤的儿科患者的NECCT和FPCCT进行回顾性评估。两名放射科医生分别在每个CT方案上评估肺结节、磨玻璃影、小叶间隔增厚、胸腔积液、胸膜增厚、心包积液、支气管内病变和血管内转移。
本研究纳入30名男孩和20名女孩（平均年龄 = 10岁3个月）。病变包括结节（NECCT检测到333个（中位数 = 3），CECCT检测到336个（中位数 = 3））、磨玻璃影（NECCT检测到12个（中位数 = 0），CECCT检测到15个（中位数 = 0））、小叶间隔增厚（NECCT检测到12个（中位数 = 0），CECCT检测到11个（中位数 = 0））。NECCT和FPCCT研究中钙化结节（n = 36）、胸腔积液（n = 1）、胸膜增厚（n = 3）、血管内血栓（n = 2）和纵隔淋巴结（n = 1）的匹配率为100%。NECCT和FPCCT在显示所有病变的能力上无统计学显著差异。NECCT和FPCCT之间的大多数差异来自运动伪影、吸气不足和放射科医生的判断，而非造影剂注射本身的影响。
在评估非血液系统胸外恶性肿瘤的肺转移方面，NECCT与FPCCT一样有效。对于评估该人群的肺转移，仅NECCT就足够了。
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