孤立性肺结节良性与恶性对比课件.pptVIP

Solitarypulmonarynodule:benignversusmalignant孤立性肺结节：良性与恶性对比

nThedifferentialdiagnosisofasolitarypulmonarynoduleisbroadandmanagementdependsonwhetherthelesionisbenignormalignant.n孤立性肺结节的鉴别诊断是很多的，处理方法依赖于该病变是良性还是恶性InthisoverviewwewilldiscusssomeofthenewfeaturesthatcanhelptodifferentiatebetweenbenignandmalignantnodulesbaseduponCTandPET-CTfindings.n在此篇文章，我们着重讨论下一些有助于鉴别良恶性结节的新特征，此特征是基于CT与PET-CT的检查结果

CT:benignversusmalignantnCalcificationnSizenGrowthnShapenMarginnAirBronchogramsignnSolidandGround-glasscomponentsnContrastenhancement

CT:良性与恶性n钙化n大小n生长速度n形状n边缘n支气管含气征n实性或磨玻璃样n增强特征

Calcification钙化nDiffuse,central,laminatedorpopcorncalcificationsarebenignpatternsofcalcification.n弥漫性，中心性，分层，爆米花钙化是良性钙化，

nThesetypesofcalcificationareseeningranulomatousdiseaseandhamartomasn这些形式的钙化最常见于错构瘤、肉芽肿性病变

nTheexceptiontotheruleaboveiswhenpatientsareknowntohaveaprimarytumor.Forinstancethediffusecalcificationpatterncanbeseeninpatientswithosteosarcomaorchondrosarcoma.SimilarlythecentralandpopcornpatterncanbeseeninpatientswithGI-tumorsandpatientswhopreviouslyhadchemotherapy.n一些病人有原发肿瘤病史，可以表现为良性钙化n例如骨肉瘤、软骨肉瘤可以表现弥漫性钙化。n胃肠间质瘤的病人化疗后可以表现为中心性或苞米花钙化。

Size大小nAsolitarypulmonarynodule(SPN)isdefinedasasingleintraparenchymallesionlessthan3cminsizeandnotassociatedwithatelectasisorlymphadenopathy.Alesiongreaterthan3cmindiameteriscalledamass.孤立性结节定义为小于3cm，不伴有肺不张、淋巴结转移，大于3cm的为肿块nThisdistinctionismade,becauselesionsgreaterthan3cmareusuallymalignant,whilesmallerlesionscanbeeitherbenignormalignant.n以3cm为界，因为大于3cm的通常是恶性的，而小于3cm的可能是良性或恶性。

RelationshipbetweenSPN-sizeandchanceofmalignancyinpatientswithhighriskforlungcancer结节大小与恶性度具有密切相关性

Growth生长速度nComparisonwithpriorimagingstudiesisoftenthemostusefulproceduretodeterminetheimportanceofthefindingofaSPN,sincestabilityover2yearsishighlyasso