Department of Radiology, Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, China.
Department of Radiation Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yishan Road, Shanghai, 200233, China.
Eur Radiol. 2019 Aug;29(8):4333-4340. doi: 10.1007/s00330-018-5970-5. Epub 2019 Jan 28.
To evaluate quantitative parameters of nonsolid nodules on paired inspiratory and expiratory computed tomography (CT) and to examine whether these parameters are sensitive to lung inflation reflected by lung volume.
Thirty-three patients with 41 nonsolid nodules were included in this prospective study. Paired inspiratory and low-dose respiratory plain chest CT were performed. The volume and density of nonsolid nodule(s), both lungs, the right and left lung, and five lobes, were analyzed in inspiratory and expiratory CT scans. The ratio of expiratory to inspiratory parameters was calculated and labeled as parameter. To standardize the changes in nonsolid nodule quantitative parameters, the ratio of nonsolid nodule parameter to lung parameter was also calculated. Quantitative parameters were compared between inspiratory and expiratory CT.
Nonsolid nodule volumes on expiratory CT were reduced by 19.8% ± 12.9%, while the density was increased by 11.4% ± 8.8%. The volume of nonsolid nodules was significantly greater on inspiratory compared with expiratory CT (p < 0.001). The density of nonsolid nodules was significantly greater on expiratory than inspiratory CT (p < 0.001). The volume was significantly greater than density both in nonsolid nodules and lung. The volume and density of nonsolid nodules were independent of size. The density of nonsolid nodule was greater in the lower lobe than that in the upper lobe (p = 0.002).
Volume changes in nonsolid nodules were more sensitive than density changes in expiratory phase. The density of lower lobe nodules was more susceptible to respiration. Expiratory scanning is not recommended for quantification of nonsolid nodules and/or follow-up.
• The nonsolid nodule volume on expiratory CT was reduced by 19.8% ± 12.9%. • The nonsolid nodule density on expiratory CT was increased by 11.4% ± 8.8%. • The volume and density of nonsolid nodules were independent of size.
评估吸气相与呼气相计算机断层扫描（CT）中肺不张结节的定量参数，并研究这些参数是否对反映肺充气状态的肺容积变化敏感。
本前瞻性研究纳入 33 例 41 个肺不张结节患者。患者行吸气相与低剂量呼吸平扫 CT 检查。在吸气相与呼气相 CT 扫描中对肺不张结节、双肺、右肺和左肺以及 5 个肺叶的体积和密度进行分析。计算呼气相与吸气相参数的比值，并将其标记为参数。为了使肺不张结节定量参数的变化标准化，还计算了肺不张结节参数与肺参数的比值。比较吸气相与呼气相 CT 的定量参数。
肺不张结节在呼气相 CT 上的体积减少了 19.8%±12.9%，而密度增加了 11.4%±8.8%。与呼气相 CT 相比，肺不张结节在吸气相 CT 上的体积明显更大（p<0.001）。与呼气相 CT 相比，肺不张结节在吸气相 CT 上的密度明显更大（p<0.001）。无论是在肺不张结节还是在肺中，体积都明显大于密度。肺不张结节的体积和密度均与大小无关。下叶肺不张结节的密度大于上叶（p=0.002）。
在呼气相中，肺不张结节的体积变化比密度变化更敏感。下叶结节的密度更容易受到呼吸的影响。不建议对肺不张结节和/或随访进行呼气相扫描进行定量。
呼气相 CT 上的肺不张结节体积减少了 19.8%±12.9%。
呼气相 CT 上的肺不张结节密度增加了 11.4%±8.8%。
肺不张结节的体积和密度与大小无关。
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