MULTIPLE PULMONARY NODULES DETECTED BY COMPUTED-TOMOGRAPHY - DIAGNOSTIC IMPLICATIONS
MULTIPLE PULMONARY NODULES DETECTED BY COMPUTED-TOMOGRAPHY - DIAGNOSTIC IMPLICATIONS
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DOI：
10.1097/00004728-198509000-00007
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发表时间：
1985-01-01
影响因子：
1.3
通讯作者：
BOOKSTEIN, FL
中科院分区：
文献类型：
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作者：
GROSS, BH;GLAZER, GM;BOOKSTEIN, FL
在CT出现之前，影像学显示多发性非粟粒性肺结节通常提示转移瘤的存在，或肉芽肿的可能性较小。CT在检测小实质肺密度时的灵敏度增加伴随着特异性的丧失，这使得在任何个体患者中CT检测到的结节的意义不确定。在1年的时间内，我们审查了我们机构中所有显示三个或更多局灶性肺密度的CT扫描，并记录了这些参数：密度数量、最大病变大小、目视确定的钙化存在和病变形态（线性或结节状）。在137例CT显示3个或3个以上局灶性肺密度的患者中，114例根据病理或临床诊断为结节。转移占73%，其中原发性结肠和肺恶性肿瘤和淋巴瘤是最常见的原因。恶性结节在统计学上显著更大、更多、更圆，而钙化与良性疾病显著相关。然而，没有任何一个标准或标准的组合是万无一失的。根据我们的研究结果，我们提供了建议，进一步评估结节在几个常见的临床设置。
Prior to the advent of CT, the radiographic demonstration of multiple nonmiliary lung nodules usually indicated the presence of metastases or, less likely, granulomas. The increased sensitivity of CT at detecting small parenchymal pulmonary densities is accompanied by loss specificity, creating uncertainty as to the significance of nodules detected at CT in any individual patient. During a 1 year period we reviewed all CT scans in our institution demonstrating three or more focal lung densities, noting these parameters: number of densities, maximum lesion size, presence of calcification as determined visually, and lesion morphology (linear or nodular). Of 137 patients with three or more focal lung densities at CT, nodule diagnosis was established on pathologic or clinical grounds in 114. Metastases accounted for 73% with primary colon and lung malignancies and lymphoma the most common causes. Malignant nodules were statistically significantly larger, more numerous, and more rounded, whereas calcification was significantly associated with benign disease. However, no single criterion or combination of criteria was foolproof. Based on our results, we offer recommendations for further evaluation of nodules in several common clinical settings.