肺结节诊断方法的最新进展

Recent advances in diagnosis of pulmonary nodule

随着健康体检的普及和低剂量螺旋CT的广泛应用, 肺部结节的检出率逐年升高。在这类筛查出的肺结节患者中, 经过手术判定的假阳性率仍然较高。因此, 如何通过必要而准确的诊断避免过度治疗或治疗不足, 如何减轻患者心理压力并定期进行影像学随访, 如何明确手术适应证、并采取最微创的诊疗方式等一系列问题, 都面临着巨大的挑战。近十年来, 肺结节的诊断技术有了长足进步, 影像学方面包括传统成像技术的优化(CT、MRI)和新技术的探索(影像组学、人工智能), 组织学方面包括经皮穿刺活检支气管镜检和外科微创手术等, 不断追求精准和微创是其努力的方向。

With the popularization of health screening and the widespread use of low-dose computed tomography,the detection rate of lung nodules has increased year after year.However,the false positive rates testified by surgery of these lung nodules are still high.Therefore,it is vital in clinical practice to avoid overtreatment or undertreatment.But a series of problems on how to make an accurate diagnosis,how to reduce the psychological pressure of patients and follow up with regular imaging,how to clarify the indications for surgery and adopt the most minimally invasive diagnosis and treatment methods,etc.remain unsolved.Over the past decade,the diagnostic techniques for pulmonary nodules have improved significantly,including imaging progress such as the optimization of traditional imaging techniques(CT,MRI)and the emergence of new technologies(radiomics,artificial intelligence).In addition,histological improvements including percutaneous transthoracic needle biopsy,bronchoscopy,and minimally invasive surgical biopsy,etc.have brought more reliable and precise options for characterization of pulmonary nodules.