摘要
目的分析在恶性肿瘤患者腹部CT检查中偶然发现的肺结节及其临床意义。方法在医院PACS系统以“占位”、“结节”或“肿块”为关键词搜索,对1年内的腹部CT报告进行搜索并评估。排除之前有胸部或腹部CT检查且/或非癌患者。结果9159次腹部CT检查中有1889例报道了肺部的“占位”,“结节”或“肿块”(1889/9159,20.6%),这其中只有252名为初诊患者,在这252名患者中,43名随访了胸部CT、腹部CT或胸腹部CT,且确诊为恶性肿瘤。既往没有接受过胸部或腹部CT,而1324名(1324/1576,84.0%)既往接受过CT检查,既被排除在研究之外。在剩余的252名患者中,有43名患者(43/252,17.1%)诊断为恶性肿瘤且接受了以胸部CT(n=16),腹部CT(n=13)或胸腹部(n=14)形式的随访CT。恶性肿瘤包括:原发性肝癌(n=21,其中肝细胞肝癌19例,肝内胆管细胞癌2例),结、直肠癌(n=8),胰腺癌(n=5),胃癌(n=5),膀胱癌(n=2),子宫颈癌(n=2)。43名患者中有21名(48.9%)患者的肺结节诊断为恶性。转移的肺结节多为类圆形、边界清楚的实性结节,常位于肺外围。结论在恶性肿瘤患者腹部CT上同时观察肺部情况是有必要的。胸部CT肺结节的良恶性特征鉴别可能也适用于恶性肿瘤患者腹部CT上偶然发现的肺结节。
Objective To analyze the pulmonary nodules accidentally found in abdominal CT examination of patients with malignant tumors and its clinical significance.Methods In the hospital PACS system,the"occupation","nodule"or"lumps"were searched for keywords,and the abdominal CT report within 1 year was searched and evaluated.Patients with chest or abdominal CT and/or non-cancer prior to exclusion were excluded.Results Of the 9159 abdominal CT scans,1889 cases reported"occupation","nodule"or"lumps"(1889/9159,20.6%)in the lungs.Of these,only 252 cases were newly diagnosed,and 43 of them were followed up for chest CT,abdominal CT,or chest and abdomen CT,and were diagnosed with malignant tumors.Previously,no chest or abdominal CT was received,and 1,324 cases(1324/1576,84.0%)had previously undergone CT examinations and were excluded from the study.Of the remaining 252 patients,43 cases(43/252,17.1%)were diagnosed with malignancy and received chest CT(n=16),abdominal CT(n=13)or chest and abdomen(n=14).Malignant tumors included primary liver cancer(n=21,19 cases of hepatocellular carcinoma,2 cases of intrahepatic cholangiocarcinoma),nodules,rectal cancer(n=8),pancreatic cancer(n=5),gastric cancer(n=5),bladder cancer(n=2),and cervical cancer(n=2).Pulmonary nodules were diagnosed as malignant in 21 of 43 patients(48.9%).The metastatic lung nodules were mostly round,solid bordered solid nodules,often located in the periphery of the lungs.Conclusion It is necessary to observe the lungs simultaneously on the abdominal CT of patients with malignant tumors.The identification of benign and malignant features of chest CT pulmonary nodules may also be applicable to pulmonary nodules accidentally found on abdominal CT in patients with malignant tumors.
作者
肖静
余倩雯
XIAO Jing;YU Qian-wen(Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment,the Affiliated Cancer Hospital of Chongqing University,Chongqing 400030,China)
出处
《临床肺科杂志》
2020年第2期191-195,共5页
Journal of Clinical Pulmonary Medicine
关键词
多层螺旋CT
腹部
肺结节
随访
multi-slice spiral CT
abdomen
pulmonary nodules
follow-up