Department of Radiology, Vancouver General Hospital, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9.
Radiology. 2010 Mar;254(3):949-56. doi: 10.1148/radiol.09090031.
To describe and characterize the potential for malignancy of noncalcified lung nodules adjacent to fissures that are often found in current or former heavy smokers who undergo computed tomography (CT) for lung cancer screening.
Institutional review board approval and informed consent were obtained. Baseline and follow-up thin-section multidetector CT scans obtained in 146 consecutive subjects at high risk for lung cancer (age range, 50-75 years; > 30 pack-year smoking history) were retrospectively reviewed. Noncalcified nodules (NCNs) were categorized according to location (parenchymal, perifissural), shape, septal connection, manually measured diameter, diameter change, and lung cancer outcome at 7(1/2) years.
Retrospective review of images from 146 baseline and 311 follow-up CT examinations revealed 837 NCNs in 128 subjects. Of those 837 nodules, 234 (28%), in 98 subjects, were adjacent to a fissure and thus classified as perifissural nodules (PFNs). Multiple (range, 2-14) PFNs were seen in 47 subjects. Most PFNs were triangular (102/234, 44%) or oval (98/234, 42%), were located inferior to the carina (196/234, 84%), and had a septal connection (171/234, 73%). The mean maximal length was 3.2 mm (range, 1-13 mm). During 2-year follow-up in 71 subjects, seven of 159 PFNs increased in size on one scan but were then stable. The authors searched a lung cancer registry 7(1/2) years after study entry and found 10 lung cancers in 139 of 146 study subjects who underwent complete follow-up; none of these cancers had originated from a PFN.
PFNs are frequently seen on screening CT scans obtained in high-risk subjects. Although PFNs may show increased size at follow-up CT, the authors in this study found none that had developed into lung cancer; this suggests that the malignancy potential of PFNs is low. (c) RSNA, 2010.
描述并确定与裂 隙相邻的非钙化性肺结节的恶性潜能，这些结节常见于目前或曾经大量吸烟且接受肺癌筛查 CT 检查的患者。
本研究获得了机构审查委员会批准和知情同意。回顾性分析了 146 例高危肺癌患者（年龄 50-75 岁，吸烟史＞30 包年）的基线和随访薄层多排 CT 扫描资料。根据位置（实质内、裂旁）、形状、间隔连接、手动测量直径、直径变化以及 7.5 年时的肺癌结果对非钙化性结节（NCN）进行分类。
回顾性分析 146 例基线和 311 例随访 CT 检查的图像，在 128 例患者中发现了 837 个 NCN。在这些结节中，234 个（28%）位于 98 例患者的裂旁，因此被归类为裂旁结节（PFN）。47 例患者存在多个（2-14 个）PFN。大多数 PFN 呈三角形（102/234，44%）或椭圆形（98/234，42%），位于隆突下（196/234，84%），有间隔连接（171/234，73%）。最大长度平均值为 3.2mm（范围，1-13mm）。在 71 例患者的 2 年随访中，159 个 PFN 中有 7 个在一次扫描中增大，但随后保持稳定。研究人员在研究开始后 7.5 年检索了肺癌登记处，在接受完整随访的 146 例研究对象中发现了 139 例中的 10 例肺癌；这些癌症均未起源于 PFN。
在高危患者的筛查 CT 扫描中经常可以看到 PFN。虽然 PFN 在随访 CT 上可能会增大，但本研究未发现任何 PFN 发展为肺癌；这表明 PFN 的恶性潜能较低。
