The Diagnostic Value Of Multi-slice CT (MSCT) Volume Rendering (VR) Three-dimensional Reconstruction For Solitary Pulmonary Nodules (SPNs)

Objective the aim of this study is to evaluate the diagnostic value of multi-slice CT (MSCT) Volume Rendering (VR) three-dimensional reconstruction for solitary pulmonary nodules (SPNs).Method design and collect the VR three-dimensional reconstruction images and surgical pathology data of the patient with SPN (a total of 48 cases), and the diameter of all the nodules is not more than 2cm. According to the nodular morphology the relationship with blood vessels and with the pleura, all VR images data is analyzed.All images, according to the form, were divided into two type:type I, leaf surface points, spine, or long antenna-like clumps; type II, smooth surface approximation rule of mass, or characterized by multiple small clumps pyramiding and become. Relationship with blood vessels was divided into three type:type I, two or more bulky blood vessels are packaged around by nodule partial or total; type â…¡, only 1 bulky blood vessel is packaged around by nodule partial or total; type â…¢, bulky blood vessels near even far away from the nodules or only a tiny blood vessels through the nodules. Relations with pleura were divided into three type:type I, nodule does not have a wide base contact with the pleura (e.g., contact a article belt), peripheral pleural change the pull cohesive; type II, a broader base contact(pleural lesion side> two-thirds of the scope of the contact with pleura), the pleura is concentrated to the center around the creases or pull cohesion; type III, nodule and pleura show wide base contact, pleura around the nodule is flat or toward the center gathered around the ruffle shape change,. Then contrast with postoperative pathologic results.Results 67 cases patients,42 cases (62.7%) for lung cancer,25 cases (37.3%) for benign lesions. Nodular morphology characterized by I type 42 cases, according to postoperative pathological,37 cases (88.1%) were malignant,5 cases (11.9%) were benign; type II 25 cases,5 cases (20.0%) were malignant, and 20 cases (80.0%) were benign. The difference of benign and malignant nodules morphology was statistically significant (P< 0.05).The relationship with blood vessels,39cases show I type, according to postoperative pathology,36 cases (92.3%) were malignant,3 cases (7.7%) were benign; II type 11 cases,6 cases (54.5%) malignant,5 cases (45.5%) benign;III 17 cases,17 cases (100%) were benign lesions. The difference was statistically significant (P< 0.05). A total of 29 cases show contact with pleura nodules, characterized by â…  type 15 cases,13 cases (86.7%) were malignant,2 cases (13.3%) benign; â…¡ type 8 cases,7 cases (87.5%) were malignant,1 case (12.5%) was benign; type â…¢6 cases,6 cases of postoperative pathology (100%) were benign lesions. Difference was statistically significant (P<0.05).Nodules form performance for â…  type, the relationship with blood vessels show the type I nodules, 35 cases of postoperative pathology in 32 (91.4%) as malignant,3 cases (8.6%) were benign; type â…¡,5 cases were malignant; type â…¢ in 2 cases, all were benign. Nodules form performance for â…¡ type, the relationship between vascular performance for I type 4 cases, all were malignant; â…¡ type 6 cases,1 malignant and 5 benign and III 15 cases, postoperative pathology were benign. Nodular morphology and relationship with blood vessels are type â… ,12 cases show type â… ,12 cases (100%) were malignant; with pleura characterized by type â…¡ 6 cases,5 cases (83.3%) as malignant,1 case (16.7%) was benign; type â…¢1 case, postoperative pathology was benign. When the nodular morphology for type â… , relationship with blood vessels for type â…¡, relationship with pleura for type â…¡ 1 case, for malignant. When the nodular morphology for type â… , relationship with blood vessels for type â…¢, and pleural relationship for â…  type in 2 cases, all are benign. When the nodular morphology for â…¡ type, relationship with blood vessels for â…  type, and pleural relationship as â…  type has 1 case, postoperative pathology was malignant. When the nodular morphology for â…¡ type, relationship with blood vessels for â…¢ type, relation with pleura for â…  and â…¢ had1 case and 5 cases respectively, postoperative pathology were benign.Conclusion multi-slice CT Volume Rendering three-dimensional reconstruction detailed and three-dimensional display the morphological characteristics of solitary pulmonary nodules, the relationship with blood vessels and with pleura, points when nodule in the leaf, spines or tentacles, two or more bulky blood vessels were surrounded by nodules, with or without nodules contact with pleura and pleura around to the centre of the creases or pull cohesion changes, we should be more vigilant about the possibility of the vicious. Volume rendering three-dimensional reconstruction is helpful to identification of benign and malignant solitary pulmonary nodules, worthy of clinical application.