| Objective:To investigate the proportion and diagnostic techniques of pulmonary nodules,and the relationship between the diseases and computed tomography (CT) characteristics.Methods:Pulmonary nodules were found in198consecutive patients which underwent multi-detector CT.148(74.7%) consecutive cases of pulmonary nodules which have been confirmed by pathology and/or clinic visits were included in this prospective trial.148cases of pulmonary nodules were divided into two groups on the basis of nodule’s nature:malignant and benign group. And on the basis of nodule’s type, we divided them into three parts. Part one, clinical analysis of19consecutive cases of pulmonary mixed ground-glass opacity nodule; Part two, clinical analysis of89consecutive cases of pulmonary solid nodule; Part three, clinical analysis of40consecutive cases of pulmoanry multi-nodule. The clinical and radiological characteristics of all patients were recorded, including site of lesion, size, number, edge characteristics and internal characteristics and etc. These parameters were statistically compared between the two groups in three parts.Results:In the148cases,39(26.4%) and109(73.6%) were benign and malignant diseases, respectively. Part one, There were4(21.1%) benign and15(78.9%) malignant mGGO nodule. No statistical differences were found between benign and malignant mGGO nodule in terms of demographic data, lesions’size, internal characteristics and external manifestations. The frequency of lobulation (86.8%,13/15), well-defined interface (86.8%,2/15) and vascular convergence(80.0%,12/15) was significantly higher in malignant mGGO nodule than that in benign mGGO nodule. The percentage of GGO component≤50%was higher in malignant mGGO nodule, too (p=0.016). The diagnostic of11cases were confirmed through percutaneous lung biopsy under multi-CT guidance.Part two, in the89cases of pulmonary solid nodule,18(20.2%) and71(79.8%) were benign and malignant diseases, respectively. Compared to the malignant group, the patients in benign group had a more febrile frequency (P<0.01). There were more cases of positive CEA in malignant’s blood than in benign’s blood (39.4%vs.5.6%). The CT features including vascular convergence (39.0%,25/71),mediastinal lymphadenopathy (28.2%,20/71) in malignant group were significantly higher in malignant than that in benign group. But the vacuole sign was more frequent in benign group (41.0%vs.8.0%). The diagnostic accuracy of CT-guided percutaneous lung biopsy was94.1%(48/51), and bronchoscopy was just43.5%(30/69). No statistical differences were found between benign and malignant in terms of demographic data, size of lesion, edge and internal characteristics, also in the external manifestations. Part three, in the40cases of pulmoanry multi-nodules,17(42.5%) and23(57.5%) were benign and malignant diseases, respectively. Compared to the benign group, the patients in malignant group were older (50.1±19.0yrs vs.61.6±10.5yrs)(p=0.000) and have more patients with positive CEA (39.1%vs.5.9%)(p=0.026). Meanwhile, more malignant cases (16/40) were older than60years (p=0.000).21cases in malignant group saw a doctor consciously because of various symptoms (p=0.015). The CT features of the biggest pulmoanry nodule including lobulation (87.0%), mediastinal lymphadeno pathy (43.5%) in malignant group were significantly higher than that in benign group (52.9%vs.5.9%). But the Sharp sign was more frequent in benign group (58.8%vs.17.4%). In this study, the main diagnostic were CT-guided transthoracic lung biopsy and bronchoscopy, and the ratio of the checked cases to the confirmed of both diagnostic were94.7%(18/19) vs.46.4%(13/28), respectively.Conclusion:The main disease of148consecutive cases pulmoanry nodules were malignant, especially if it’s pulmonary solid nodule. The CT characteristics and CEA have certain significance in the differential diagnosis of lesions properties of pulmonary nodules. CT-guided percutaneous lung biopsy is a useful diagnostic technique. Bronchoscopy is limited in diagnosis of them. |
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