| PurposeSolitary pulmonary inflammatory nodule(SPIN)was frequently misdiagnosed as malignancy.We aimed to investigate CT features and pathological findings of SPINs for improving diagnosis strategies.Patients and methodsIn this retrospective study,225 and 310 patients with respectively confirmed SPINs and lung cancerous nodules were enrolled from January2013 to December 2020.Nodules were classified into different types based on the key CT features: I,homogeneous and well-defined nodules with smooth(Ia),coarse(Ib),or spiculated margins(Ic);II,nodules with blurred boundaries,peripheral patches,or both;III,nodules exhibiting heterogeneous density;and IV,polygonal nodules.The pathological findings of SPINs were simultaneously studied and summarized.ResultsAmong the 225 SPINs,type I(Ia,Ib,Ic),II,III,and IV were 137(60.9%)[47(34.3%),33(24.1%),57(41.6%)],62(27.6%),12(5.3%)and14(6.2%),respectively.Correspondingly,those nodules in 310 cancerous were 275(88.7%)[119(43.3%),70(25.5%),86(31.3%)],20(6.5%),15(4.8%),and 0,respectively.Compared with lung cancers,type I nodules were less common,but type II and IV nodules were more common in SPINs(each p<0.0001).Though the frequencies of subtype I(p=0.095)and type III(p=0.796)nodules were similar between two groups,their specific CT features were significantly different.The main pathological findings of each type of SPINs were most extensively identical(82.2%-100%).ConclusionBetween cancerous nodules and SPINs,differences in overall or specific CT features exist.The type II and IV nodules are highly indicative of SPINs,and each type of SPINs have almost similar pathological findings.ObjectiveLobulation sign is helpful for determining pulmonary pure ground-glass nodule(p GGN).The purpose of this study was to explore the value of multislice spiral CT multiple planner reconstruction(MPR)and volume rending(VR)techniques in evaluating the lobulation sign of p GGN.MethodsIn this retrospective study,78 patients with confirmed 82 p GGNs were enrolled from January 2016 to February 2019,including AAHs 11(13.4%),AISs 24(29.3%),MIAs 30(36.6%),and IAs 17(20.7%).The absence and degree of lobulation sign were evaluated on the axial,coronal,sagittal MPR image and the VR image.The lobulation degree was defined as 3levels: no lobulation: 0 score;lobulation but not significant: 1 score;significant lobulation: 2 score.The results were classified and compared to evaluate the differences of lobulation signs among different observation angles and methods.ResultsThere was no significant difference in lobulation sign scores on the axial,coronal or sagittal MPR images(p>0.05).The lobulation sign scores of all the nodules on the VR images were significantly higher than these on different directions MPR images and the highest score of MPR(p(27)0.001).There was no significant difference between the highest lobulation sign scores of MPR and the scores of VR in AAH,AIS,MIA and IA(p>0.05),The highest lobulation sign scores of MPR and the scores of VR in IA were higher than these scores in AAH and MIA(p<0.05)。Compared with AIS,the highest lobulation sign scores of MPR in IA were higher(p=0.005),while there was no significant difference in lobulation sign scores between the two groups on VR images(p=0.064).For the highest lobulation sign scores of MPR and the scores of VR,there was no significant difference between invasive lesions(MIA+IA)and preinvasive lesions(AAH+AIS)(p>0.05),while there was significant difference in lobulation sign scores between the aggressive lesions(IA)and nonaggressive lesions(AAH+AIS+MIA)(p<0.05).On the MPR images,the highest lobulation sign scores of MPR of the bigger(≥10mm)p GGNs were significantly higher than the smaller nodules(<10mm)(p=0.017),while there was no significant difference in lobulation sign scores between the two groups on VR images(p=0.128).ConclusionThe lobulation degree of p GGN is related to its size and nature.By using multidetector computed tomography(MDCT)post-processing techniques MPR and VR,it is more comprehensive and intuitive to evaluate the lobulation sign of p GGN and can provide valuable information for judging its nature. |
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