title: [Dynamic enhanced CT evaluation of solitary pulmonary nodules].
abstract: OBJECTIVE
  To evaluate the value of dynamic enhanced-CT in differential diagnosis of solitary pulmonary nodules.
  
  
  METHODS
  Sixty-three solitary pulmonary nodules were evaluated by dynamic enhanced multi-slice CT. Images were obtained before and at 20 s, 30 s, 45 s, 60 s, 75 s, 90 s, 120 s, 180 s, 300 s, 540 s, 720 s, 900 s and 1200 s after the injection of contrast media. All lesion enhanced parameters and morphological features were recorded. The differences between benign and malignant nodules were analyzed. The diagnostic sensitivity and specificity of solitary pulmonary nodules were evaluated by receiver operator characteristic analysis.
  
  
  RESULTS
  CT enhancement value at 120 s [(29.5 ± 30.2) HU vs. (32.5 ± 14.7) HU, P = 0.023], washout at 20 min [(36.5 ± 24.6) HU vs. (15.6 ± 16.6) HU, P = 0.044], washout ratio at 20 min [(36.5 ± 24.6)% vs. (17.8 ± 14.5)%, P = 0.006], slope of washout at 20 min [(0.006 ± 0.005)%/s vs. (0.002 ± 0.0016)%/s, P = 0.001], type II (24/42 vs. 4/21, P = 0.004) and III (5/42 vs. 9/21, P = 0.005) curves were significantly different between benign and malignant nodules. Using the above mentioned parameters, the results of receiver operator characteristic analysis had a sensitivity of 64.3% and specificity of 84.2% for identification of malignant tumors. The morphological features including round-like, triangle-like, multi-angle, spiculation, light lobulation, the degree of edge (sharp, clear, blur), vessel convergence sign, vacuole sign, airing of bronchi, cut-off of the bronchi and depression of pleura were significantly different between benign and malignant nodules. The results of ROC analysis showed that the above mentioned morphological features had a sensitivity of 92.9% and specificity of 100% for differentiating malignant tumors from benign nodules. The results of ROC analysis showed that combination of morphological features and dynamic enhancement parameters had a sensitivity of 95.2% and specificity of 100% for identification of malignant tumors.
  
  
  CONCLUSIONS
  Dynamic enhanced CT images can evaluate morphological and enhancement features of solitary pulmonary nodules. Combination of morphological features and enhancement characteristics can improve the accuracy of diagnosis.
authors.affiliation: Department of Radiology, Affiliated Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China.
authors.forename: Xiao-dan
authors.initials: XD
authors.lastname: Ye
authors.forename: Zheng
authors.initials: Z
authors.lastname: Yuan
authors.forename: Jian-ding
authors.initials: JD
authors.lastname: Ye
authors.forename: Hui-min
authors.initials: HM
authors.lastname: Li
authors.forename: Xiang-sheng
authors.initials: XS
authors.lastname: Xiao
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging; D003110:Colonic Neoplasms / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006222:Hamartoma / Q000000981:diagnostic imaging; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed / Q000379:methods*; D014375:Tuberculoma / Q000000981:diagnostic imaging; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media