Blood flow patterns of solitary pulmonary nodules with enhancement

Abstract

Objective

To evaluate the efficacy of dynamic multi-slice spiral computed tomography (MSCT) for providing quantitative information about blood flow patterns of solitary pulmonary nodules (SPNs).

Methods

Seventy-eight patients with SPNs (diameter ≤ 4 cm; 68 malignant; 10 active inflammatory) were underwent multi-location dynamic contrast material-enhanced serial CT (nonionic contrast material was administrated via the antecubital vein at a rate of 4 mL/s by using an autoinjector, 4 × 5 mm or 4 × 2.5 mm transverse scanning mode with stable table were performed). Sixteen series CT scans (16 scans each for the first and second series and one scan each for the rest series) were obtained during 9 min scanning period. Precontrast and postcontrast attenuation on every scan was recorded. Perfusion, peak height and ratio of peak height of the SPN to that of the aorta were calculated. Perfusion was calculated from the maximum gradient of the time-attenuation curve and the peak height of the aorta.

Results

No statistically significant difference in the peak height was found between malignant (35.79 ± 10.76 Hu) and active inflammatory (39.76 ± 4.59 Hu) (t = 1.148, P = 0.255 > 0.05). SPN-to-aorta ratio (14.27% ± 4.37) and perfusion value (30.18 mL/min/100 g ± 9.58) in malignant SPNs were significantly lower than those of active inflammatory (18.51% ± 2.71, 63.44 mL/min/100 g ± 43.87) (t = 2.978, P = 0.004 < 0.05; t = 5.590, P < 0.0001).

Conclusion

The quantitative information about blood flow patterns of malignant and active inflammatory SPNs is different. SPN-to-aorta ratio and perfusion value are helpful in differentiating malignant nodules from active inflammatory.