Division of Pulmonology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Department of Radiology, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Turk J Pediatr. 2022;64(3):466-473. doi: 10.24953/turkjped.2021.4858.
There exists insufficient information about the natural course of incidental pulmonary nodules (IPN) determined on tomography in children. The aim was to determine the characteristic features and factors affecting the course of IPN.
This retrospective study included patients who presented at the Pediatric Pulmonology, Allergy & Immunology Section of Akdeniz University Hospital between January 2014-2020, and were determined with pulmonary nodules on high-resolution computed tomography (HRCT). The patients were separated into two groups as those with a nodule decreased in size or which had disappeared on the follow-up HRCT (Group 1) and those with a nodule which had remained at the same size (Group 2). These two groups were compared in respect to demographic data, nodule size and characteristics, and accompanying findings on HRCT.
A total of 177 nodules were determined in the 66 patients included in the study. A follow-up HRCT was taken within mean 16.29±11.38 months in 27 patients. In these patients, 78 nodules were determined on the initial HRCT. On the follow-up, twelve of the nodules were seen to have shrunk or disappeared compared to the initial images, 66 had remained the same size, and none had grown. The mean age of the patients in Group 1 was statistically significantly lower than that of patients in Group 2 (p < 0.001). The rates of an accompanying mosaic attenuation pattern (p < 0.001) on HRCT and subsolid density (p=0.011) of the nodules in Group 1 were statistically significantly higher compared to Group 2 and the rate of calcification content was statistically significantly lower (p=0.002). No suspicious or confirmed malignancy was observed in any case throughout the mean follow-up period of 38.33±16.5 months after the initial HRCT.
The young age of patients, subsolid structure of nodules, calcification content and the presence of an accompanying mosaic attenuation pattern on HRCT, could be useful factors in the estimation of size in the follow-up of nodules.
在儿童胸部高分辨率计算机断层扫描（HRCT）上偶然发现的肺结节（IPN）的自然病程信息不足。本研究旨在确定 IPN 的特征和影响其病程的因素。
本回顾性研究纳入了 2014 年至 2020 年期间在阿克登兹大学医院儿科肺病、过敏和免疫学科就诊并在 HRCT 上发现肺结节的患者。将患者分为两组，一组为结节在随访 HRCT 中缩小或消失（组 1），另一组为结节大小保持不变（组 2）。比较两组患者的一般资料、结节大小和特征以及 HRCT 上的伴随发现。
本研究共纳入 66 例患者的 177 个结节。27 例患者在平均 16.29±11.38 个月时进行了随访 HRCT。在这些患者中，78 个结节在初始 HRCT 上发现。在随访中，与初始图像相比，12 个结节缩小或消失，66 个结节大小保持不变，没有结节增大。组 1 患者的平均年龄明显低于组 2（p<0.001）。组 1 中 HRCT 存在马赛克衰减模式（p<0.001）和部分实质性结节（p=0.011）的比例明显高于组 2，而钙化含量明显低于组 2（p=0.002）。在初始 HRCT 后平均 38.33±16.5 个月的随访期间，没有可疑或确诊的恶性肿瘤。
患者年龄较小、结节的部分实质性结构、钙化含量和 HRCT 上存在马赛克衰减模式，这些因素可能有助于评估结节在随访中的大小变化。
