Heaston D K, Putman C E, Rodan B A, Nicholson E, Ravin C E, Korobkin M, Chen J T, Seigler H F
AJR Am J Roentgenol. 1983 Jul;141(1):169-74. doi: 10.2214/ajr.141.1.169.
A prospective comparison of chest radiography, conventional tomography, and computed tomography (CT) in the detection or confirmation of solitary pulmonary nodules was made in 42 patients with high propensity for pulmonary metastases due to advanced local (Clark level IV or V) or regional malignant melanoma. Unequivocal nodules were revealed by chest radiography in 11 patients, conventional tomography in 16, and computed tomography in 20 patients. Both plain films and tomography in three of these 20 were normal, but follow-up verified pulmonary metastases. Computed tomography detected more pulmonary nodules than conventional tomography in 11 patients in addition to identifying lesions in extrapulmonary sites. Therefore, chest CT is recommended before institution of immunotherapy or surgical removal of a solitary pulmonary melanoma metastasis. Once chemotherapy had been instituted for bulky regional or cutaneous involvement, however, the findings of either conventional or computed tomography were comparable in this study.
对42例因局部晚期（克拉克IV级或V级）或区域恶性黑色素瘤而有高肺转移倾向的患者，进行了胸部X线摄影、传统体层摄影和计算机断层扫描（CT）在检测或确认孤立性肺结节方面的前瞻性比较。胸部X线摄影在11例患者中发现了明确的结节，传统体层摄影在16例中发现，计算机断层扫描在20例中发现。这20例中有3例的平片和体层摄影均正常，但随访证实有肺转移。计算机断层扫描除了能识别肺外部位的病变外，在11例患者中比传统体层摄影检测到更多的肺结节。因此，在进行免疫治疗或手术切除孤立性黑色素瘤肺转移之前，建议进行胸部CT检查。然而，一旦因广泛的区域或皮肤受累而开始化疗，在本研究中传统体层摄影或计算机断层扫描的结果相当。
