Chest CT frequently reveals small pulmonary lesions. If there is no associated hilar or mediastinal lymphadenopathy, small-cell lung cancer (SCLC) is considered to be very early-stage. Few studies, however, have descr...Chest CT frequently reveals small pulmonary lesions. If there is no associated hilar or mediastinal lymphadenopathy, small-cell lung cancer (SCLC) is considered to be very early-stage. Few studies, however, have described the characteristic CT findings of very early-stage SCLC. Clarifying these findings would reduce diagnostic delay. The purpose of this study was to determine the characteristic CT findings of very earlystage SCLC. Computed tomography images obtained from 547 consecutive patients with lung cancer between 2003 and 2012 at Tokyo Dental College Ichikawa General Hospital were reviewed retrospectively. One hundred of these patients had SCLC and 447 had non-SCLC (NSCLC). These CT images, along with any that had also been obtained prior to the one on which the final diagnosis was based, were reviewed. In 5 of the cases reviewed, specific findings and a characteristic spreading pattern were identified on CT images that might have allowed a diagnosis of SCLC to have been made sooner. The findings included a sub-pleural, small nodule accompanied by daughter nodules spreading longitudinally along the bronchovascular bundle, no air bronchogram or cavitation, and background emphysematous change. These were not identified on CT images of very earlystage NCSLC, however (n = 22). Awareness of the relevance of these findings would help physicians and radiologists arrive at a differential diagnosis of small pulmonary nodules.展开更多
目的 探讨高分辨肺薄层成像及延迟显像对低代谢的肺实性小结节的诊断意义。方法 选择2020年1月至2022年1月在合肥京东方医院经病理诊断的低代谢的肺实性小结节患者21例,其中男性12例,女性9例;年龄41~85岁,平均年龄58.75岁;结节直径0.6~2...目的 探讨高分辨肺薄层成像及延迟显像对低代谢的肺实性小结节的诊断意义。方法 选择2020年1月至2022年1月在合肥京东方医院经病理诊断的低代谢的肺实性小结节患者21例,其中男性12例,女性9例;年龄41~85岁,平均年龄58.75岁;结节直径0.6~2.0 cm,平均直径1.17 cm;经病理诊断,良性13例,恶性8例。先行PET/CT常规显像,然后行肺薄层CT扫描及延迟显像,半定量法测定结节常规及延迟期最大标准摄取值(SUVmax),并分析延迟显像与常规显像SUVmax差值(ΔSUVmax),计算其诊断的灵敏度、特异度和准确度。所得结果分别与病理检查结果对照比较。结果 PET/CT常规加做薄层CT显像,两者联合的灵敏度为72.7%,特异度为86.7%,准确度为80.7%,明显高于单一者。与病理诊断结果对照,结合SUVmax差值分析,恶性病灶大多数ΔSUVmax≥常规显像的SUVmax100%,诊断准确度为87.5%;而良性病灶多数ΔSUVmax <常规显像的SUVmax100%,诊断准确度为84.6%。恶性肺实性小结节常规与延迟显像SUVmax平均值高于良性病变患者,差异有统计学意义(2.77±0.39 vs 1.67±0.38,4.78±0.42 vs 2.49±0.33。P <0.05);恶性结节的平均ΔSUVmax及差值率较良性结节显著增加,差异有统计学意义(2.12±0.31 vs 0.82±0.26,25.59±12.87 vs 8.72±5.59。P <0.05)。表明评估延迟显像ΔSUVmax及差值率能进一步提高准确度。结论 加做肺薄层CT扫描和同时实施PET/CT延迟显像可以显著提高低代谢的肺实性小结节的诊断准确度,尤其对于低代谢(SUVmax≤3.45)小结节的预测价值较高。展开更多
文摘Chest CT frequently reveals small pulmonary lesions. If there is no associated hilar or mediastinal lymphadenopathy, small-cell lung cancer (SCLC) is considered to be very early-stage. Few studies, however, have described the characteristic CT findings of very early-stage SCLC. Clarifying these findings would reduce diagnostic delay. The purpose of this study was to determine the characteristic CT findings of very earlystage SCLC. Computed tomography images obtained from 547 consecutive patients with lung cancer between 2003 and 2012 at Tokyo Dental College Ichikawa General Hospital were reviewed retrospectively. One hundred of these patients had SCLC and 447 had non-SCLC (NSCLC). These CT images, along with any that had also been obtained prior to the one on which the final diagnosis was based, were reviewed. In 5 of the cases reviewed, specific findings and a characteristic spreading pattern were identified on CT images that might have allowed a diagnosis of SCLC to have been made sooner. The findings included a sub-pleural, small nodule accompanied by daughter nodules spreading longitudinally along the bronchovascular bundle, no air bronchogram or cavitation, and background emphysematous change. These were not identified on CT images of very earlystage NCSLC, however (n = 22). Awareness of the relevance of these findings would help physicians and radiologists arrive at a differential diagnosis of small pulmonary nodules.
文摘目的 探讨高分辨肺薄层成像及延迟显像对低代谢的肺实性小结节的诊断意义。方法 选择2020年1月至2022年1月在合肥京东方医院经病理诊断的低代谢的肺实性小结节患者21例,其中男性12例,女性9例;年龄41~85岁,平均年龄58.75岁;结节直径0.6~2.0 cm,平均直径1.17 cm;经病理诊断,良性13例,恶性8例。先行PET/CT常规显像,然后行肺薄层CT扫描及延迟显像,半定量法测定结节常规及延迟期最大标准摄取值(SUVmax),并分析延迟显像与常规显像SUVmax差值(ΔSUVmax),计算其诊断的灵敏度、特异度和准确度。所得结果分别与病理检查结果对照比较。结果 PET/CT常规加做薄层CT显像,两者联合的灵敏度为72.7%,特异度为86.7%,准确度为80.7%,明显高于单一者。与病理诊断结果对照,结合SUVmax差值分析,恶性病灶大多数ΔSUVmax≥常规显像的SUVmax100%,诊断准确度为87.5%;而良性病灶多数ΔSUVmax <常规显像的SUVmax100%,诊断准确度为84.6%。恶性肺实性小结节常规与延迟显像SUVmax平均值高于良性病变患者,差异有统计学意义(2.77±0.39 vs 1.67±0.38,4.78±0.42 vs 2.49±0.33。P <0.05);恶性结节的平均ΔSUVmax及差值率较良性结节显著增加,差异有统计学意义(2.12±0.31 vs 0.82±0.26,25.59±12.87 vs 8.72±5.59。P <0.05)。表明评估延迟显像ΔSUVmax及差值率能进一步提高准确度。结论 加做肺薄层CT扫描和同时实施PET/CT延迟显像可以显著提高低代谢的肺实性小结节的诊断准确度,尤其对于低代谢(SUVmax≤3.45)小结节的预测价值较高。
