Howe M A, Gross B H
Comput Radiol. 1987 Mar-Apr;11(2):61-7. doi: 10.1016/0730-4862(87)90012-6.
In the setting of a questionable pulmonary nodule demonstrated by conventional radiographs, the place of CT in the diagnostic algorithm is not well established. We reviewed our experience in 50 consecutive patients referred to CT for a "possible pulmonary nodule." From the chest radiographs we noted nodule location, maximum dimension, presence on one or both views, and presence on a previous radiograph (greater than 1 year old), and nodules were categorized as "likely" or "unlikely" to be real parenchymal lesions based on radiographic appearance. Of a total of 56 questionable nodules, CT demonstrated no abnormality in 21 cases, parenchymal nodules in 16, scarring, atelectasis, or infiltrate in 11, and normal structural variants in 8. True pulmonary nodules were statistically significantly more frequently categorized as "likely" lesions than normal variants or no disease, but this was not of a magnitude to be clinically useful. Based on analysis of various radiographic features of equivocal nodules and their subsequent outcomes, we suggest a radiologic approach to the equivocal pulmonary nodule.
在传统X线片显示可疑肺结节的情况下，CT在诊断流程中的地位尚未明确确立。我们回顾了连续50例因“可能的肺结节”而接受CT检查的患者的经验。从胸部X线片上，我们记录了结节的位置、最大直径、在一个或两个视图上的显示情况以及在先前X线片（超过1年）上的显示情况，并根据X线表现将结节分类为“可能”或“不太可能”是真正的实质病变。在总共56个可疑结节中，CT显示21例无异常，16例为实质结节，11例为瘢痕、肺不张或浸润，8例为正常结构变异。真正的肺结节在统计学上被归类为“可能”病变的频率显著高于正常变异或无病变，但这种差异在临床上并无太大用处。基于对可疑结节的各种X线特征及其后续结果的分析，我们提出了一种针对可疑肺结节的放射学诊断方法。
