A Practical Algorithmic Approach to the Diagnosis and Management of Solitary Pulmonary Nodules

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A Practical Algorithmic Approach to the Diagnosis and Management of Solitary Pulmonary Nodules. 背景. 孤立性肺部结节( solitary pulmonary nodule , SPN )的定义:影像学显示的直径 ≤3cm 、边缘 2/3 以上被肺组织包绕的肺部高密度影,需除外淋巴结、肺不张及阻塞性肺炎。 胸片检查可发现 0.09%-7% 的 SPN 。胸部 CT 扫描则可发现 8%-51% 的 SPN 。 恶性肿瘤的比例为 1.1%-12% 。. 鉴别诊断. 感染性疾病. 新生物. - PowerPoint PPT Presentation

Text of A Practical Algorithmic Approach to the Diagnosis and Management of Solitary Pulmonary Nodules

  • solitary pulmonary noduleSPN3cm2/30.09%-7%SPNCT8%-51%SPN1.1%-12%

  • WegenerMPA

  • CTPET-CTMRI

  • IPF

  • CT/

  • SPN20-40010040020730

    10mm8-10mm8mm

  • 3cm

    3cm

  • SPN

  • CT200Hu

  • CT-40~-120Hu60%

  • 5mm

    15mm

  • CT2PET

  • PET-CTSUVStandardized uptake value

  • CT8mm

  • PET8-10mm

    10mm

  • SUVSUVFDGSUV2.52

  • PET-CT8-10mmSPNPETPETSPN2SPN

  • MRIMRISPN

    MRIslope of enhancement ratio0.04/s96.3%, 82.1%, 95.7%, 84.2%, 93.6%CTPET-CT

    MRISPN

  • Pretest ProbabilitySPNAge is the patient's age in years, smoke = 1 if the patient is a current or former smoker (otherwise, smoke = 0), diameter is the diameter of the nodule in millimeters, spiculation = 1 if the edge of the nodule has spicules (otherwise, spiculation = 0), and location = 1 if the nodule is located in an upper lobe (otherwise, location = 0).

  • Practical Algorithmic Approach to the SPN

  • SPNSPN8mm8mmCT8mmPET-CTPET-CT

    5mm5mmCT25mm3PET-CT

  • IPF9-38%*CT1mm*4mm11-5mmCT*PETCTCTPET*CT2SPN2SPNCTSPNCT*TTNATBBxSPN8mmFleischner SocietySPN8mm5%Fleischner Society60%5-60%PET-CTPETACCPPETCT361224*SPN5mm5mm3CTSPN3CT3PET-CTSPNPET-CT8mmPET-CTCT*