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The relationships of the pulmonary arteries to lung lesions aid in differential diagnosis using computed tomography.

Lin CH, Li TC, Tsai PP, Lin WC - Biomedicine (Taipei) (2015)

Bottom Line: The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8%, respectively (P = 0.011).The ROC curve showed that the degree of pulmonary arterial encasement had a moderate discriminating ability in diagnosing lung carcinoma, and the area under the curve was 0.738.The best cutoff value was 44.4%.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Children's Hospital, China Medical University Hospital, 404, Taichung, Taiwan.

ABSTRACT
The improvement of the resolution of rapid scanning in multidetector computed tomography (CT) has an increased accuracy that allows for the demonstration of the relationship of the pulmonary arteries and lung lesions, even in the peripheral lung. The purpose of this study is to evaluate the relationship between the pulmonary arteries and lung lesions by CT, and to use this relationship to distinguish between benign and malignant lung lesions. The relationships of the lung lesions and the adjacent pulmonary artery were recorded as encasement, displacement, penetration, in the margin, and disconnection. Statistical analyses were then performed to evaluate the relationship of the pulmonary arteries to each lesion with a focus toward the possibility of malignancy and the degree of pulmonary arterial encasement in the lesion. The relationship between the pulmonary arteries and lung lesions had a statistically significant difference between benignancy and malignancy (P < 0.001). Inter-observer agreement was substantial (κ = 0.639; 95% CI: 0.518-0.719). The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8%, respectively (P = 0.011). The ROC curve showed that the degree of pulmonary arterial encasement had a moderate discriminating ability in diagnosing lung carcinoma, and the area under the curve was 0.738. The best cutoff value was 44.4%. The relationships of the pulmonary arteries to lung lesions and the degree of pulmonary arterial encasement could be used in differentiating benignancy from malignancy not only for central lung lesions but also peripheral lung lesions.

No MeSH data available.


Related in: MedlinePlus

Encasement. This is an 82-year-old male with a mass lesion abutting the left hilum. He received bronchoscopic biopsy and pathology revealed small cell lung carcinoma. Coronal (A) and axial (B) section computed tomography (CT) images reveal the main tumor envelops the left segmental pulmonary artery, with decrease in the diameter of this artery (white arrows).
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Fig1: Encasement. This is an 82-year-old male with a mass lesion abutting the left hilum. He received bronchoscopic biopsy and pathology revealed small cell lung carcinoma. Coronal (A) and axial (B) section computed tomography (CT) images reveal the main tumor envelops the left segmental pulmonary artery, with decrease in the diameter of this artery (white arrows).

Mentions: The definition of encasement is a mass enveloping a pulmonary artery while decreasing the size of a pulmonary artery’s caliber (Figure 1). Displacement indicates a mass is causing deviation of a pulmonary artery away from the normal vascular course with/without a notch in the pulmonary artery (Figure 2). Penetration is when a pulmonary artery passes through the lesion without changing the vascular course or caliber of that pulmonary artery (Figure 3). In the margin is when a pulmonary artery passes across the lesion’s margin but without changing its vascular course or its caliber. Disconnection is when there is no pulmonary artery contact with the lesion. More than one type of relationships would be recorded if more than one pulmonary artery was in connection with the lesion. The degree of mass effect in order is encasement, displacement, and then penetration. The mass effect that cannot be clarified as a lesion is the mass effect that involves disconnection or in the margin to/with a pulmonary aftery, so these types of lesions were not included in the statistical analyses. Finally, the observers recorded the relationship of each pulmonary artery with the most mass effect of each lesion in the statistical analyses.


The relationships of the pulmonary arteries to lung lesions aid in differential diagnosis using computed tomography.

Lin CH, Li TC, Tsai PP, Lin WC - Biomedicine (Taipei) (2015)

Encasement. This is an 82-year-old male with a mass lesion abutting the left hilum. He received bronchoscopic biopsy and pathology revealed small cell lung carcinoma. Coronal (A) and axial (B) section computed tomography (CT) images reveal the main tumor envelops the left segmental pulmonary artery, with decrease in the diameter of this artery (white arrows).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4502046&req=5

Fig1: Encasement. This is an 82-year-old male with a mass lesion abutting the left hilum. He received bronchoscopic biopsy and pathology revealed small cell lung carcinoma. Coronal (A) and axial (B) section computed tomography (CT) images reveal the main tumor envelops the left segmental pulmonary artery, with decrease in the diameter of this artery (white arrows).
Mentions: The definition of encasement is a mass enveloping a pulmonary artery while decreasing the size of a pulmonary artery’s caliber (Figure 1). Displacement indicates a mass is causing deviation of a pulmonary artery away from the normal vascular course with/without a notch in the pulmonary artery (Figure 2). Penetration is when a pulmonary artery passes through the lesion without changing the vascular course or caliber of that pulmonary artery (Figure 3). In the margin is when a pulmonary artery passes across the lesion’s margin but without changing its vascular course or its caliber. Disconnection is when there is no pulmonary artery contact with the lesion. More than one type of relationships would be recorded if more than one pulmonary artery was in connection with the lesion. The degree of mass effect in order is encasement, displacement, and then penetration. The mass effect that cannot be clarified as a lesion is the mass effect that involves disconnection or in the margin to/with a pulmonary aftery, so these types of lesions were not included in the statistical analyses. Finally, the observers recorded the relationship of each pulmonary artery with the most mass effect of each lesion in the statistical analyses.

Bottom Line: The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8%, respectively (P = 0.011).The ROC curve showed that the degree of pulmonary arterial encasement had a moderate discriminating ability in diagnosing lung carcinoma, and the area under the curve was 0.738.The best cutoff value was 44.4%.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Children's Hospital, China Medical University Hospital, 404, Taichung, Taiwan.

ABSTRACT
The improvement of the resolution of rapid scanning in multidetector computed tomography (CT) has an increased accuracy that allows for the demonstration of the relationship of the pulmonary arteries and lung lesions, even in the peripheral lung. The purpose of this study is to evaluate the relationship between the pulmonary arteries and lung lesions by CT, and to use this relationship to distinguish between benign and malignant lung lesions. The relationships of the lung lesions and the adjacent pulmonary artery were recorded as encasement, displacement, penetration, in the margin, and disconnection. Statistical analyses were then performed to evaluate the relationship of the pulmonary arteries to each lesion with a focus toward the possibility of malignancy and the degree of pulmonary arterial encasement in the lesion. The relationship between the pulmonary arteries and lung lesions had a statistically significant difference between benignancy and malignancy (P < 0.001). Inter-observer agreement was substantial (κ = 0.639; 95% CI: 0.518-0.719). The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8%, respectively (P = 0.011). The ROC curve showed that the degree of pulmonary arterial encasement had a moderate discriminating ability in diagnosing lung carcinoma, and the area under the curve was 0.738. The best cutoff value was 44.4%. The relationships of the pulmonary arteries to lung lesions and the degree of pulmonary arterial encasement could be used in differentiating benignancy from malignancy not only for central lung lesions but also peripheral lung lesions.

No MeSH data available.


Related in: MedlinePlus