Lung nodule enhancement at CT:: Multicenter study

被引:453
作者
Swensen, SJ
Viggiano, RW
Midthun, DE
Müller, NL
Sherrick, A
Yamashita, K
Naidich, DP
Patz, EF
Hartman, TE
Muhm, JR
Weaver, AL
机构
[1] Mayo Clin & Mayo Fdn, Dept Diagnost Radiol, Rochester, MN 55905 USA
[2] Mayo Clin & Mayo Fdn, Div Pulm & Crit Care Med & Internal Med, Rochester, MN 55905 USA
[3] Mayo Clin Scottsdale, Div Pulm Med, Scottsdale, AZ USA
[4] Mayo Clin Scottsdale, Dept Diagnost Radiol, Scottsdale, AZ USA
[5] Mayo Clin Scottsdale, Biostat Sect, Scottsdale, AZ USA
[6] Vancouver Gen Hosp, Dept Diagnost Radiol, Vancouver, BC, Canada
[7] Mem Med Ctr, Dept Diagnost Radiol, Springfield, IL 62781 USA
[8] Shiga Hlth Insurance Hosp, Dept Diagnost Radiol, Otsu, Shiga, Japan
[9] NYU Med Ctr, Dept Diagnost Radiol, New York, NY 10016 USA
[10] Duke Univ, Med Ctr, Dept Diagnost Radiol, Durham, NC USA
关键词
lung; CT; nodule; lung neoplasms; diagnosis;
D O I
10.1148/radiology.214.1.r00ja1473
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To test the hypothesis that absence of statistically significant lung nodule enhancement (less than or equal to 15 HU) at computed tomography (CT) is strongly predictive of benignity. MATERIALS AND METHODS: Five hundred fifty lung nodules were studied. Of these, 356 met all entrance criteria and had a diagnosis. On nonenhanced, thin-section CT scans, the nodules were solid, 5-40 mm in diameter, relatively spherical, homogeneous, and without calcification or fat. All patients were examined with 3-mm-collimation CT before and after intravenous injection of contrast material. CT scans through the nodule were obtained at 1, 2, 3, and 4 minutes after the onset of injection. Peak net nodule enhancement and time-attenuation curves were analyzed. Seven centers participated. RESULTS: The prevalence of malignancy was 48% (171 of 356 nodules). Malignant neoplasms enhanced (median, 38.1 HU; range, 14.0-165.3 HU) significantly more than granulomas and benign neoplasms (median, 10.0 HU; range, -20.0 to 96.0 HU; P < .001). With 15 HU as the threshold, the sensitivity was 98% (167 of 171 malignant nodules), the specificity was 58% (107 of 185 benign nodules), and the accuracy was 77% (274 of 356 nodules). CONCLUSION: Absence of significant lung nodule enhancement (less than or equal to 15 HU) at CT is strongly predictive of benignity.
引用
收藏
页码:73 / 80
页数:8
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