Multi-Slice Spiral CT Perfusion Imaging for Blood Supply of Pulmonary Mixed Ground-Glass Nodules_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

BaoJunhui ¹ , YanQiaohuan ² , LiuZhenxing ³ , WangJunying ¹ ^# ,  LvYinggang ¹

1. Image Second Division, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, 056002, China;
2. ;
3. ;

Corresponding author：

LvYinggang, Email: lvying23gang@126.com

Keywords：

CT perfusion imaging; Pulmonary ground-glass nodules; Blood supply; Diagnosis

DOI：

10.7507/1671-6205.2016065

Video：

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Objective To investigate the clinical value of multi-slice spiral CT perfusion imaging for blood supply of pulmonary mixed ground-glass nodules (mGGN). Methods The mGGN patients were retrospectively analyzed from March 2011 to May 2015 in Affiliated Hospital of Hebei University of Engineering, Handan First Hospital and Xingtai People's Hospital. Multi-slice spiral CT perfusion imaging for blood supply was applied to evaluate the blood supply of solid lesions in mGGN, and the diagnostic values of CT perfusion parameters were compared for differentiating the benigh mGGN from the malignant mGGN. Results Totally 97 mGGN patients were enrolled in this study, in which 80 were malignant mGGN and 17 were benigh mGGN. Blood volume (BV), peak enhancement image (PEI) and permeability surface (PS) in malignant mGGN lesions were higher than those of benign lesions, while the time to peak was less than that of benign lesions, and the differences were all statistically significant (P < 0.05). BV, PEI and PS in minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) patients were significantly higher than those in the patients with precancerous lesions (P < 0.05). BV and PS in IAC patients were significantly higher than those in MIA patients (P < 0.05). Logistic regression analysis showed that IAC, MIA and the precancerous lesions, BV, PEI and PS were positively correlated with mGGN. Receiver operating characteristic (ROC) curve showed that the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rates with BV+PS+PEI combined, were 95.28%, 86.65%, 91.10%, 87.52% and 91.76%, respectively, while the area under ROC curve was significantly higher than those with single parameter (P < 0.05). Conclusion Multi-slice spiral CT perfusion imaging can evaluate the blood supply of mGGN, and BV+PS+PEI combined can be used in differentiation of the benigh and malignant mGGN.

Citation： Bao Junhui, Yan Qiaohuan, Liu Zhenxing, Wang Junying, Lv Yinggang. Multi-Slice Spiral CT Perfusion Imaging for Blood Supply of Pulmonary Mixed Ground-Glass Nodules. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(3): 279-283. doi: 10.7507/1671-6205.2016065 Copy

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7.	杨淑琴, 侯铁, 张千, 等.多层螺旋CT灌注成像技术在孤立性肺结节诊断及鉴别诊断中的应用.吉林大学学报(医学版), 2008, 34:890-893.
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9.	Zhao YR, de Bock GH, Vliegenthart R, et al. Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume. Eur Radiol, 2012, 22:2076-2084.
10.	谭泽兵, 张子曙, 王云华, 等.多层螺旋CT灌注成像评价肺癌的血供特征.湖南师范大学学报(医学版), 2009, 6:42-47.
11.	Xiang WJ, Xing YF, Jiang S, et al. Morphological factors differentiating between early lung adenocarcinomas appearing as pure ground-glass nodules measuring≤10 mm on thin-section computed tomography. Cancer Imaging, 2014, 14:33.
12.	Ma ZJ, Yang GZ, Wang J. Analysis of 96 cases of solitary pulmonary nodule diagnosed by MSCT. Chinese-German J Clin Oncol, 2014, 13:115-118.
13.	袁小东, 敖国昆, 全昌斌, 等.肺双重血供的CT灌注技术及其应用于肺结核的初步研究.中华临床医师杂志(电子版), 2011, 5:5913-5919.

1. Barr MP, Gray SG, Gately K, et al. Vascular endothelial growth factor is an autocrine growth factor, signaling through neuropilin-1 in non-small cell lung cancer. Mol Cancer, 2015, 14:45.
2. Xie XQ, Zhao YR, Snijder RA, et al. Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16-and 64-row multi-detector CT: an anthropomorphic phantom study. Eur Radiol, 2013, 23:139-147.
3. 周安乐, 周康荣, 颜志平, 等.利用CT灌注成像研究转移性肺癌的血供.中华放射学杂志, 2007, 41:366-371.
4. Aoki T. Growth of pure ground-glass lung nodule detected at computed tomography. J Thorac Dis, 2015, 7:E326-E328.
5. Poruk KE, Kim Y, Cameron JL, et al. What is the significance of indeterminate pulmonary nodules in patients undergoing resection for pancreatic adenocarcinoma. J Gastrointest Surg, 2015, 19:841-847.
6. 阮超美, 陈文静, 郑列, 等.CT灌注成像在肺部肿物诊断及鉴别诊断中的应用研究.癌症, 2007, 26:78-83.
7. 杨淑琴, 侯铁, 张千, 等.多层螺旋CT灌注成像技术在孤立性肺结节诊断及鉴别诊断中的应用.吉林大学学报(医学版), 2008, 34:890-893.
8. Valente G, Mamo C, Bena A, et al. Prognostic significance of microvessel density and vascular endothelial growth factor expression in sinonasal carcinomas. Hum Pathol, 2006, 37:391-400.
9. Zhao YR, de Bock GH, Vliegenthart R, et al. Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume. Eur Radiol, 2012, 22:2076-2084.
10. 谭泽兵, 张子曙, 王云华, 等.多层螺旋CT灌注成像评价肺癌的血供特征.湖南师范大学学报(医学版), 2009, 6:42-47.
11. Xiang WJ, Xing YF, Jiang S, et al. Morphological factors differentiating between early lung adenocarcinomas appearing as pure ground-glass nodules measuring≤10 mm on thin-section computed tomography. Cancer Imaging, 2014, 14:33.
12. Ma ZJ, Yang GZ, Wang J. Analysis of 96 cases of solitary pulmonary nodule diagnosed by MSCT. Chinese-German J Clin Oncol, 2014, 13:115-118.
13. 袁小东, 敖国昆, 全昌斌, 等.肺双重血供的CT灌注技术及其应用于肺结核的初步研究.中华临床医师杂志(电子版), 2011, 5:5913-5919.

Chinese Journal of Respiratory and Critical Care Medicine

Multi-Slice Spiral CT Perfusion Imaging for Blood Supply of Pulmonary Mixed Ground-Glass Nodules

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