Ko Jane P, Naidich David P
Department of Radiology, New York University School of Medicine, NYU Langone Medical Center, New York, New York..
Department of Radiology, New York University School of Medicine, NYU Langone Medical Center, New York, New York.
Semin Thorac Cardiovasc Surg. 2014 Summer;26(2):145-56. doi: 10.1053/j.semtcvs.2014.07.001. Epub 2014 Jul 16.
Persistent subsolid nodules, part-solid or pure ground-glass attenuation, are associated with primary lung adenocarcinoma, recently redefined by the International Association for the Study of Lung Cancer-American Thoracic Society-European Respiratory Society in 2011 and include newly categorized entities of adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic-predominant adenocarcinoma. Awareness of the relationship of the subsolid nodule with adenocarcinoma has emerged in the era of high-resolution multidetector computed tomography (CT). This article highlights the role of noninvasive CT for subsolid nodules with an emphasis on the potential for quantitative measures to predict adenocarcinoma subtypes and their longitudinal behavior. Of particular importance is the knowledge that an increase in solid components on CT is an indication of progression. Continued experience in evaluating quantitative measures in combination with morphologic features, including margin contour, internal architecture, and nodule size, will further aid in guiding crucial decisions pertaining to the use of CT surveillance vs more invasive approaches including biopsy and surgical resection.
持续性亚实性结节,部分实性或纯磨玻璃密度影,与原发性肺腺癌相关,2011年国际肺癌研究协会-美国胸科学会-欧洲呼吸学会对原发性肺腺癌进行了重新定义,其中包括原位腺癌、微浸润腺癌和以鳞屑样生长为主的腺癌等新分类实体。在高分辨率多排螺旋计算机断层扫描(CT)时代,人们已经认识到亚实性结节与腺癌之间的关系。本文重点介绍了无创CT对亚实性结节的作用,强调了定量测量预测腺癌亚型及其纵向变化的潜力。特别重要的是要知道CT上实性成分增加是病变进展的一个指标。结合形态学特征(包括边缘轮廓、内部结构和结节大小)评估定量测量的持续经验,将进一步有助于指导有关采用CT监测还是包括活检和手术切除在内的更具侵入性方法的关键决策。