Multi-detector spiral CT study of the relationships between pulmonary ground-glass nodules and blood vessels
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Multi-detector spiral CT study of the relationships between pulmonary ground-glass nodules and blood vessels Feng Gao & Ming Li & Xiaojun Ge & Xiangpeng Zheng & Qingguo Ren & Yan Chen & Fangzhen Lv & Yanqing Hua
Received: 3 March 2013 / Revised: 6 June 2013 / Accepted: 7 June 2013 # European Society of Radiology 2013
Abstract Objective To investigate the relationships between pulmonary ground-glass nodules (GGN) and blood vessels and their diagnostic values in differentiating GGNs. Methods Multi-detector spiral CT imaging of 108 GGNs was retrospectively reviewed. The spatial relationships between GGNs and supplying blood vessels were categorized into four types: I, vessels passing by GGNs; II, intact vessels passing through GGNs; III, distorted, dilated or tortuous vessels seen within GGNs; IV, more complicated vasculature other than described above. Relationship types were correlated to pathologic and/or clinical findings of GGNs. Results Of 108 GGNs, 10 were benign, 24 preinvasive nodules and 74 adenocarcinomas that were pathologically proven. Types I, II, III and IV vascular relationships were observed in 9, 58, 21 and 20 GGNs, respectively. Type II relationship was the dominating relationship for each GGN group, but significant differences were shown among them. Correlation analysis showed strong correlation between invasive adenocarcinoma and type III and IV relationships. Subgroup analysis
indicated that type III was more commonly seen in IAC with comparison to type IV more likely seen in MIA. Conclusion Different GGNs have different relationships with vessels. Understanding and recognising characteristic GGN-vessel relationships may help identify which GGNs are more likely to be malignant. Key Points • Multi-detector CT offers new information about groundglass nodules • In particular we can now study their relationship with vessels • Different types of ground-glass nodules have different relationships with vessels • This may help identify which ground-glass nodules are likely to be malignant Keywords Vessel . Ground-glass nodule . Tomography . Adenocarcinoma . X-ray computed
Introduction
F. Gao : M. Li : X. Ge : Q. Ren : Y. Hua (*) Department of Radiology, Huadong Hospital Fudan University, 221 West Yan’an Road, Shanghai 200040, China e-mail: [email protected] X. Zheng (*) Department of Radiation Oncology, Huadong Hospital Fudan University, 221 West Yan’an Road, Shanghai 200040, China e-mail: [email protected] Y. Chen Department of Pathology, Huadong Hospital Fudan University, Shanghai 200040, China F. Lv Department of Thoracic Surgery, Huadong Hospital Fudan University, Shanghai 200040, China
With the extensive acceptance of low-dose multi-detector spiral CT in lung cancer screening [1], the number of detected ground-glass nodules (GGNs) or focal ground-glass opacities (fGGOs) has dramatically increased. GGNs can result from neoplasms, such as pulmonary adenocarcinoma, or benign diseases, such as focal fibrosis, inflammation or alveolar haemorrhage. In addition, pre-invasive abnormalities, incl
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