Nghiên cứu đặc điểm hình ảnh cắt lớp vi tính ngực trong chẩn đoán nốt đơn độc ở phổi có đường kính lớn hơn 8mm

Abstract

Objective: To identify the characteristics and malignant indicative features of solitary pulmonary nodules on thoracic multi detector-row computed tomography (MDCT). Subject and method: 165 patients were examined and treated in National Lung Hospital from 11/2016 to 12/2019 that had a solitary pulmonary nodule on chest CT and had results of pathology (after biopsy and / or after surgery): Prospective study, cross-sectional description. All patients were taken chest CT by Siemens 16 or 64 slices (Somatom Emotion 16 or 64, Siemens Healthcare, Germany).  Result: Solitary pulmonary nodules had a benign rate of 51.5% and malignancy of 48.5%. The average age of disease 53.5 ± 1.4. The most common age group was 49 - 69 years old (p=0.946). Male/Female ratio ~ 1.8: 1. The oval lung nodules were 73.9%, round nodules 20%. Round nodules had a high rate of benignancy (66.7%) and low malignancy (32.3%), while polygonal nodules or amorphous nodules were predominantly malignant (62.5% and 100.0%) (p = 0.075). The average diameter was 20.4 ± 5.2mm. Lung nodules with average diameter ≥20mm were likely to be 4.64 times more likely to be malignant compared to nodules with an average diameter < 20mm [p <0.001; CI (2.32 - 9.31)]. Solitary pulmonary nodules were mostly peripheral and upper lobe; right lung lesions were more than the left ones with 55.1% and 44.9%, respectively (p <0.0001). The nodule had an internal bubble of 23%, the nodules were caverned or calcified 9.8%, the nodules had a specific proportion of fat, necrosis or sickle (respectively, 3.7, 4.9 and 5.4%). Most lung cancer nodules had irregular margins and spiculate margins or combined with pleural tail sign (72.6%), benign nodules had smooth, smooth edges (90.9%). Conclusion: The solitary pulmonary nodules are clinically common and have a high malignancy rate (48.5%). High resolution MDCT plays an important role in the detailed evaluation of their morphology, position, size and contrast characteristics and provides appropriate diagnosis