Swensen S J, Brown L R, Colby T V, Weaver A L, Midthun D E
Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Radiology. 1996 Nov;201(2):447-55. doi: 10.1148/radiology.201.2.8888239.
To determine if lung nodule enhancement measured with computed tomography (CT) is directly related to the likelihood of malignancy and to nodule vascularity.
Radiologically indeterminate 7-30-mm pulmonary nodules were studied in 107 patients with malignant neoplasms (n = 52), granulomas (n = 51), and benign neoplasms (n = 4). Attenuation was recorded from serial thin-section CT scans before and after injection of contrast material. Twenty-four histologic specimens were graded after immunoperoxidase vascular staining with antibody to factor VIII-associated antigen.
Malignant neoplasms were enhanced (median, 46.5 HU; range, 11-110 HU) statistically significantly more than granulomas and benign neoplasms (median, 8 HU; range, -10 to 94 HU) (P < .001). With 20 HU as the threshold for a positive test result, the sensitivity was 98%, specificity was 73%, and accuracy was 85% (prevalence of malignancy, 49% ¿52 of 107 nodules]). The degree of enhancement was statistically significantly related to the amount of central vascular staining (P < .001).
Enhancement appears to be an indicator of malignancy and vascularity. These prospective findings corroborate previously reported results.
确定计算机断层扫描（CT）测量的肺结节强化是否与恶性可能性及结节血管形成直接相关。
对107例患有恶性肿瘤（n = 52）、肉芽肿（n = 51）和良性肿瘤（n = 4）的患者中7 - 30毫米的放射学上不确定的肺结节进行研究。在注射对比剂前后，从连续的薄层CT扫描记录衰减值。24个组织学标本在用抗VIII因子相关抗原抗体进行免疫过氧化物酶血管染色后进行分级。
恶性肿瘤的强化（中位数，46.5 HU；范围，11 - 110 HU）在统计学上显著高于肉芽肿和良性肿瘤（中位数，8 HU；范围， - 10至94 HU）（P <.001）。以20 HU作为阳性检测结果的阈值，敏感性为98%，特异性为73%，准确性为85%（恶性肿瘤的患病率，49% - 107个结节中的52个）。强化程度在统计学上与中央血管染色量显著相关（P <.001）。
强化似乎是恶性和血管形成的一个指标。这些前瞻性研究结果证实了先前报道的结果。
