BACKGROUND In recent years,the detection rate of ground-glass nodules(GGNs)has been improved dramatically due to the popularization of low-dose computed tomography(CT)screening with high-resolution CT technique.This p...BACKGROUND In recent years,the detection rate of ground-glass nodules(GGNs)has been improved dramatically due to the popularization of low-dose computed tomography(CT)screening with high-resolution CT technique.This presents challenges for the characterization and management of the GGNs,which depends on a thorough investigation and sufficient diagnostic knowledge of the GGNs.In most diagnostic studies of the GGNs,morphological manifestations are used to differentiate benignancy and malignancy.In contrast,few studies are dedicated to the assessment of the hemodynamics,i.e.,perfusion parameters of the GGNs.AIM To assess the dual vascular supply patterns of GGNs on different histopathology and opacities.METHODS Forty-seven GGNs from 47 patients were prospectively included and underwent the dynamic volume CT.Histopathologic diagnoses were obtained within two weeks after the CT examination.Blood flow from the bronchial artery[bronchial flow(BF)]and pulmonary artery[pulmonary flow(PF)]as well as the perfusion index(PI)=[PF/(PF+BF)]were obtained using first-pass dual-input CT perfusion analysis and compared respectively between different histopathology and lesion types(pure or mixed GGNs)and correlated with the attenuation values of the lesions using one-way ANOVA,student’s t test and Pearson correlation analysis.RESULTS Of the 47 GGNs(mean diameter,8.17 mm;range,5.3-12.7 mm),30(64%)were carcinoma,6(13%)were atypical adenomatous hyperplasia and 11(23%)were organizing pneumonia.All perfusion parameters(BF,PF and PI)demonstrated no significant difference among the three conditions(all P>0.05).The PFs were higher than the BFs in all the three conditions(all P<0.001).Of the 30 GGN carcinomas,14 showed mixed GGNs and 16 pure GGNs with a higher PI in the latter(P<0.01).Of the 17 benign GGNs,4 showed mixed GGNs and 13 pure GGNs with no significant difference of the PI between the GGN types(P=0.21).A negative correlation(r=-0.76,P<0.001)was demonstrated between the CT attenuation values and the PIs in the 30 GGN carcinomas.CONCLUSION The GGNs are perfused dominantly by the PF regardless of its histopathology while the weight of the BF in the GGN carcinomas increases gradually during the progress of its opacification.展开更多
This study examined the value of volume rendering （VR） interpretation in assessing the growth of pulmonary nodular ground-glass opacity （nGGO）. A total of 47 nGGOs （average size, 9.5 mm; range, 5.7-20.6 mm） were...This study examined the value of volume rendering （VR） interpretation in assessing the growth of pulmonary nodular ground-glass opacity （nGGO）. A total of 47 nGGOs （average size, 9.5 mm; range, 5.7-20.6 mm） were observed by CT scanning at different time under identical parameter settings. The growth of nGGO was analyzed by three radiologists by comparing the thin slice （TS） CT images of initial and repeat scans with side-by-side cine mode. One week later synchronized VR images of the two scans were compared by side-by-side cine mode to evaluate the nGGO growth. The nodule growth was rated on a 5-degree scale： notable growth, slight growth, dubious growth, stagnant growth, shrinkage. Growth standard was defined as： Density increase 〉 30 HU and （or） diameter increase （by 20% in nodules 〉_10 mm, 30% in nodules of 5-9 mm）. Receiver operating characteristic （ROC） was performed. The results showed that 32 nGGOs met the growth criteria （29 nGGOs showed an increase in density; 1 nGGO showed an increase in diameter; 2 nGGOs showed an increase in both diameter and density）. Area under ROC curve revealed that the performance with VR interpretation was better than that with TS interpretation （P〈0.01, P〈0.05 and P〈0.05 for observers A, B and C respectively）. Consistency between different observers was excellent with both VR interpretation （κ=0.89 for observers A＆C A＆B, B＆C） and TS interpretation （κ=0.71 for A＆B, κ=0.68 for A＆C, κ=0.74 for B＆C）, but time spending was less with VR interpretation than with TS interpretation （P〈0.0001, P〈0.0001 and P〈0.05 for observers A, B and C, respectively）. It was concluded that VR is a useful technique for evaluating the growth of nGGO.展开更多
基金Supported by the National Natural Science Foundation of China,No.81671680.
文摘BACKGROUND In recent years,the detection rate of ground-glass nodules(GGNs)has been improved dramatically due to the popularization of low-dose computed tomography(CT)screening with high-resolution CT technique.This presents challenges for the characterization and management of the GGNs,which depends on a thorough investigation and sufficient diagnostic knowledge of the GGNs.In most diagnostic studies of the GGNs,morphological manifestations are used to differentiate benignancy and malignancy.In contrast,few studies are dedicated to the assessment of the hemodynamics,i.e.,perfusion parameters of the GGNs.AIM To assess the dual vascular supply patterns of GGNs on different histopathology and opacities.METHODS Forty-seven GGNs from 47 patients were prospectively included and underwent the dynamic volume CT.Histopathologic diagnoses were obtained within two weeks after the CT examination.Blood flow from the bronchial artery[bronchial flow(BF)]and pulmonary artery[pulmonary flow(PF)]as well as the perfusion index(PI)=[PF/(PF+BF)]were obtained using first-pass dual-input CT perfusion analysis and compared respectively between different histopathology and lesion types(pure or mixed GGNs)and correlated with the attenuation values of the lesions using one-way ANOVA,student’s t test and Pearson correlation analysis.RESULTS Of the 47 GGNs(mean diameter,8.17 mm;range,5.3-12.7 mm),30(64%)were carcinoma,6(13%)were atypical adenomatous hyperplasia and 11(23%)were organizing pneumonia.All perfusion parameters(BF,PF and PI)demonstrated no significant difference among the three conditions(all P>0.05).The PFs were higher than the BFs in all the three conditions(all P<0.001).Of the 30 GGN carcinomas,14 showed mixed GGNs and 16 pure GGNs with a higher PI in the latter(P<0.01).Of the 17 benign GGNs,4 showed mixed GGNs and 13 pure GGNs with no significant difference of the PI between the GGN types(P=0.21).A negative correlation(r=-0.76,P<0.001)was demonstrated between the CT attenuation values and the PIs in the 30 GGN carcinomas.CONCLUSION The GGNs are perfused dominantly by the PF regardless of its histopathology while the weight of the BF in the GGN carcinomas increases gradually during the progress of its opacification.
基金supported by a grant from the Science and Technology Program of Guangdong Province of China(No.2009B030801120)
文摘This study examined the value of volume rendering （VR） interpretation in assessing the growth of pulmonary nodular ground-glass opacity （nGGO）. A total of 47 nGGOs （average size, 9.5 mm; range, 5.7-20.6 mm） were observed by CT scanning at different time under identical parameter settings. The growth of nGGO was analyzed by three radiologists by comparing the thin slice （TS） CT images of initial and repeat scans with side-by-side cine mode. One week later synchronized VR images of the two scans were compared by side-by-side cine mode to evaluate the nGGO growth. The nodule growth was rated on a 5-degree scale： notable growth, slight growth, dubious growth, stagnant growth, shrinkage. Growth standard was defined as： Density increase 〉 30 HU and （or） diameter increase （by 20% in nodules 〉_10 mm, 30% in nodules of 5-9 mm）. Receiver operating characteristic （ROC） was performed. The results showed that 32 nGGOs met the growth criteria （29 nGGOs showed an increase in density; 1 nGGO showed an increase in diameter; 2 nGGOs showed an increase in both diameter and density）. Area under ROC curve revealed that the performance with VR interpretation was better than that with TS interpretation （P〈0.01, P〈0.05 and P〈0.05 for observers A, B and C respectively）. Consistency between different observers was excellent with both VR interpretation （κ=0.89 for observers A＆C A＆B, B＆C） and TS interpretation （κ=0.71 for A＆B, κ=0.68 for A＆C, κ=0.74 for B＆C）, but time spending was less with VR interpretation than with TS interpretation （P〈0.0001, P〈0.0001 and P〈0.05 for observers A, B and C, respectively）. It was concluded that VR is a useful technique for evaluating the growth of nGGO.
