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Title:: Application value of energy spectrum CT in the differential diagnosis of benign and malignant pulmonary ground-glass nodule

Author(s):: AN Donghui; YANG Junxiao; QU Yalin; XIE Hui; WU Shaoquan; Department of Radiology, the Dazu District People’s Hospital/Dazu Hospital of the First Affiliated Hospital of Chongqing Medical University, Chongqing 402360, China

Keywords:: ; Keywords: lung disease; mixed ground-glass nodule; tuberculosis; computed tomography

Abstract:: Abstract: Objective To investigate the specific signs of energy spectrum computed tomography (CT) of pulmonary mixed ground-glass nodules, and to perform a differential diagnosis of minimally invasive adenocarcinoma (MIA), invasive pulmonary adenocarcinoma (IPA) and alveolar nodules (AN) based on the components of nodules and CT signs. Methods The CT scan images and clinical date of 156 patients with pulmonary mixed ground-glass nodules and AN were retrospectively analyzed and compared with the pathological results. Results A total of 221 nodules were found in 156 patients. All patients underwent surgery and pathological examination. The nodules include 62 MIA, 76 IPA, 78 AN, 3 sclerosing hemangioma and 2 inflammatory pseudotumor. The CT value of the nodules was found to be the highest in AN group, about (-40±27) HU, followed by IPA group and then MIA group, about (-102±54) and (-221±101) HU, respectively. The main CT sign in MIA, IPA, and AN groups was vacuoles (45.16%), lobulated (47.36%), and smooth margin (70.51%), respectively. Statistical differences were found in CT values and CT signs among the 3 groups (P<0.05). Conclusion The morphological feature of energy spectrum CT can identify MIA, IPA and AN, providing relevant evidences to the differential diagnosis and treatment.