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Updated: Jun 22, 2026
A 3D Digital Model for the Diagnosis and Treatment of Pulmonary Nodules
Published on: May 19, 2023
Dynamic enhancement patterns of solitary pulmonary nodules at multi-detector row CT and correlation with vascular
Nan-Chuan Jiang1, Ping Han, Cheng-Kai Zhou
1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
Background And Objective:
Differential diagnosis of malignant solitary pulmonary nodules (SPNs) from benign ones is difficult based on imaging manifestations. This study was to assess dynamic enhancement patterns of SPNs detected with multi-detector row computed tomography (MDCT), correlate SPN manifestations of MDCT to the expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD), thus to explore the potential value of MDCT imaging in the diagnosis of SPNs.
Methods:
Fifty pathologically and one clinically confirmed patients with SPNs (diameter
Results:
The peak and net enhancements were significantly higher in malignant nodules (mean attenuation, 69.9 Hu and 32.9 Hu) than in benign nodules (mean attenuation, 51.7 Hu and 17.2 Hu) (p < 0.001). When net enhancement of 20 Hu was set as the cutoff value to differentiate malignant nodules from benign ones, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 96.43%, 69.57%, 79.41%, 94.12% and 84.31%, respectively. The enhancement patterns between malignant and benign SPNs were significantly different. Homogeneous enhancement or heterogeneous tending to homogeneous enhancement appeared mostly in malignant nodules (78.57%). Benign nodules were almost not enhanced (52.17%). Expressions of MVD and VEGF were significantly different between malignant and benign SPNs. VEGF was positively correlated to the peak enhancement value (r = 0.505, p = 0.014) and the net enhancement value (r = 0.565, p = 0.005). Similarly, MVD was also positively correlated to the peak enhancement value (r = 0.819, p < 0.001) and the net enhancement value (r = 0.845, p < 0.001).
Conclusions:
Net enhancement value is an important indicator for differential diagnosis of malignant and benign SPNs. Characteristic enhancement patterns are different between malignant and benign SPNs. Peak enhancement and net enhancement values are positively correlated with VEGF and MVD, both of which reflect the extent of angiogenesis in SPNs to some extent.
