Objective： To investigate the enhancement basis and the mechanisms of solitary pulmonary nodules （SPNs） by comparing the differences in microvascular structure between benign and malignant lesions. Methods： Dynami...Objective： To investigate the enhancement basis and the mechanisms of solitary pulmonary nodules （SPNs） by comparing the differences in microvascular structure between benign and malignant lesions. Methods： Dynamic contrast-enhanced CT scan was performed on 53 patients with SPNs （diameter〈3 cm, 38 peripheral lung cancers, 5 hamartomas, 10 inflammatory lesions） using a Siemens Plus S or a Marconi MX8000 multi slices spiral CT scanner. The time-attenuation curves were interpreted. The microvascular density （MVD） and the continuity of the microvessels＇ basemental membrane in the dissected specimens were observed with the ABC （avldin-biotin complex） immuno-histochemical method in all patients. Results ：The CT enhancement values of lung cancer （49.05± 16.08 HU） and inflammatory lesions （49.59±21.30 HU） were significantly higher than those of hamartoma （8.98±4.56 HU） t=7.48, P〈0.051 t=8.35, P〈0.05）. But the enhancement of lung cancer was similar to that of inflammatory lesions （t=0.76, P±0. 05）. The time attenuation curve of inflammatory lesions tended to increase faster and reached a higher peak compared to the lung cancer, and both of them maintained a high plateau after crossing. The hamartoma showed a slight increase in the time-attenuation curve and demonstrated a lowplateau curve. The MVD of SPNs was positively correlated with CT enhancement （r=0. 8051）. The microvascular counts of peripheral lung cancer （48.45±10. 09） and inflammatory lesions （49. 60±19. 94） were significantly higher than those of hamartoma （8.70±7. 30） （t=11. 64, P〈0.001, t=6. 09, P〈0. 001 ）, but no significant difference was found between lung cancer and inflammatory lesions （t= -0.26, P=0.799）. There was no difference in the continuity of basement membrane between nodules with anen haneement less than 30 HU and those with an enhancement higher than 30HU （X^2=3. 13, P〉0.05 ）. Conclusion： The microvascular counts mainly contribute to the enhancement value of SPNs. The basement membrane is not related to nodule enhancement, but it might influence the pattern of the time-attenuation curve.展开更多
文摘Objective： To investigate the enhancement basis and the mechanisms of solitary pulmonary nodules （SPNs） by comparing the differences in microvascular structure between benign and malignant lesions. Methods： Dynamic contrast-enhanced CT scan was performed on 53 patients with SPNs （diameter〈3 cm, 38 peripheral lung cancers, 5 hamartomas, 10 inflammatory lesions） using a Siemens Plus S or a Marconi MX8000 multi slices spiral CT scanner. The time-attenuation curves were interpreted. The microvascular density （MVD） and the continuity of the microvessels＇ basemental membrane in the dissected specimens were observed with the ABC （avldin-biotin complex） immuno-histochemical method in all patients. Results ：The CT enhancement values of lung cancer （49.05± 16.08 HU） and inflammatory lesions （49.59±21.30 HU） were significantly higher than those of hamartoma （8.98±4.56 HU） t=7.48, P〈0.051 t=8.35, P〈0.05）. But the enhancement of lung cancer was similar to that of inflammatory lesions （t=0.76, P±0. 05）. The time attenuation curve of inflammatory lesions tended to increase faster and reached a higher peak compared to the lung cancer, and both of them maintained a high plateau after crossing. The hamartoma showed a slight increase in the time-attenuation curve and demonstrated a lowplateau curve. The MVD of SPNs was positively correlated with CT enhancement （r=0. 8051）. The microvascular counts of peripheral lung cancer （48.45±10. 09） and inflammatory lesions （49. 60±19. 94） were significantly higher than those of hamartoma （8.70±7. 30） （t=11. 64, P〈0.001, t=6. 09, P〈0. 001 ）, but no significant difference was found between lung cancer and inflammatory lesions （t= -0.26, P=0.799）. There was no difference in the continuity of basement membrane between nodules with anen haneement less than 30 HU and those with an enhancement higher than 30HU （X^2=3. 13, P〉0.05 ）. Conclusion： The microvascular counts mainly contribute to the enhancement value of SPNs. The basement membrane is not related to nodule enhancement, but it might influence the pattern of the time-attenuation curve.
