CT Study Of Growth Characteristic Of Solitary Pulmonary Nodules

Objective: Solitary pulmonary nodules(SPN) is a frequent incidental finding in image check of chest, The study of SPN is important to diagnosis its characteristic and found early stage lung carcinoma. Wit using of multi-slice C T(MSCT) and expansion of early check lung carci-noma, incidental discoveryof small SPN is very frequent, but CT characteristic diagnosis methods ofSP N no longer apply to diagnosis its cha-racteristic, our study observe SPN with three-dimensionalvolume reco-nstruction and evaluate growth characteristic of SPN with volume doubling time(DT) and percentage volume change(PVC), t o offer track for earl diagnosis its characteristic.Materials and methods: ollect 217 SPN by MS16-SCT scanning to three groups according experimental design.A group consist all of 217 SPN,B group consist 81 SPN by diagnosised with pathologic and clinic,C group consist 53 SPN which undergo at least two chest CT examations,all of cases checked by 16-SCT, then deale with ALA(advance lung analysis, ALA) software of GE AW4.2 workstation. A group divided into group according SPN'diamater, relationwith amphi-organize and density, then compare the reconsturuction succeed rate using rank sum test andχ~2-test; B gro-up apart solid, part-solid and nonsolid to analyse the relation of the density mode of SPN to patient's age, gender, SPN'diameter and volume.then compare the value of CT scanning and three-dimensional reconstruction using ROC (receiver operatoring characteristic curve, ROC). at 1-ast B group apart two groups with diameter compare the value of CT scanning and three-dimensional reconstruction ROC cure.C group consist 24SPN which gained effective volume DT and PVC in 53 cases (volume DTis not infinityor negtive,PVC is not zero and negtive),in these cases malignant SPN are 22 cases, two cases are benign,compare the relation of volumeDT,PVC to patient's age,gender,SPN'first diameter,firstvolume and interval time using rang correlation, then using rang correlation for PVC of exceeding 60 days and lowing 60days interval time evaluated.calculating 95% CI (95% confidence interval, 95%CI) of malig-nant SPN. Compared the media figure of volume doubling time by acco-unting volume and diameter according 118 days reported on article. u-sing rang correlation to compare the relation of volume DT and PVC.Results: all of 217 SPN are three-dimensional construction by ALA.there are high succeed rate for solitary and part-solid nodules and lower succeed rate for juxtavascular and pleural and nonsolid nodulesthe density mode of SPN are n ot correlation with patient's age,gender,SPN' diameter and volume. the di agnosis value of three-dimensional reconstruction excelled CT scanning. Volume DT of 22 malignant nodules average are 89.36+ 24.51 day (52～16 0 day), PVC of 22 malignant nodules average are44.+23.88% (17%-91%),D T and PVC of two benign nodules are 52, 1621day and 38%, 4%. There is no correlation of volume DT to patient's age, gender, SPN ' f-irst diameter and first volume. volume DT is independent factor.thereare postitive correlation of PVC and interval time, the interval time is longer, the PVC is biger, it show the tumor's characteristic gowth i-s linear.the distrubution of volume DT of 22 malignant nodules is app-roximate normal distrubution,95% CI is78.50～100.23d ay. Volume DT a-ccording with ALA is more close to volume DT of carcinom a reported by some articals. There is no correlation of volume DT and PVC.Coneulusion:1.Using advanced anaysis software for SPN can three-dimensional reconstruct and analysis SPN,and account the SPN' volume,volume DT and PVC.It had assistant value to diagnosis of SPN.2. The density mode of SPN (solid,part-solid and nonsolid) are not correlation with patient's age,gender,SPN' diameter and volume.3. the diagnosis value(especially to SPN which diameter smaller than 10 ram) of three-dimensional reconstruction excelled CT scanning.4. volume DT is independent guideline to evaluate the gowth characteristic of SPN, 95% CI of volume DT of 22 malignant nodules is 78.50～100.23 da y .PVC is assistantguideline, there are postitive correlation of PVC and interv al time, it show the tumor's characteristic gowth is linear, volume DT andP VC are guideline to evaluate the gowths characteristic of SPN, to offer track f or earl diagnosis SPN'characteristic.