Winer-Muram Helen T
Department of Radiology, Indiana University, Indianapolis, IN, USA.
Radiology. 2006 Apr;239(1):34-49. doi: 10.1148/radiol.2391050343.
The imaging evaluation of a solitary pulmonary nodule is complex. Management decisions are based on clinical history, size and appearance of the nodule, and feasibility of obtaining a tissue diagnosis. The most reliable imaging features are those that are indicative of benignancy, such as a benign pattern of calcification and periodic follow-up with computed tomography for 2 years showing no growth. Fine-needle aspiration biopsy and core biopsy are important procedures that may obviate surgery if there is a specific benign diagnosis from the procedure. In using the various imaging and diagnostic modalities described in this review, one should strive to not only identify small malignant tumors--where resection results in high survival rates--but also spare patients with benign disease from undergoing unnecessary surgery.
孤立性肺结节的影像学评估较为复杂。管理决策基于临床病史、结节的大小和外观以及获取组织诊断的可行性。最可靠的影像学特征是那些提示良性的特征，如良性钙化模式以及连续2年的计算机断层扫描随访显示无生长。如果细针穿刺活检和粗针活检能得出明确的良性诊断，则可能避免手术，这两种活检是重要的检查手段。在使用本综述中描述的各种影像学和诊断方法时，不仅应努力识别切除后生存率高的小恶性肿瘤，还应避免让患有良性疾病的患者接受不必要的手术。
