CT is a common test in daily work.
With the autumn and winter season, pulmonary diseases are more common.
Many patients are unfamiliar with chest CT report results.
So. How to read the CT report.
How should pulmonary nodules be judged.
The radiologist of our hospital will talk to you about the words of the "lungs".
With the strengthening of the public's awareness of cancer prevention and the popularization of low-dose chest CT screening, more and more people are finding pulmonary nodules during physical examination. Although many small lung nodules are benign, it is inevitable that they will be worried. So what should I do if a chest CT scan finds a lung nodule?Is it benign or malignant?Should I have a surgical excision?After getting the chest CT examination report, what should we focus on?
First, look at the density.
In general, medical imaging doctors will divide lung nodules into three types: solid nodules, partially solid nodules, and ground-glass nodules. Solid nodules appear solid and completely opaque on CT images, and we cannot see the lung markings behind them. Solid nodules are usually composed of parenchymal components such as granulation tissue, fibrous tissue, and cell proliferation. Ground-glass opacity nodules, which appear as a blurry, slightly dense opacity on CT images, resemble a small patch of frosted glass. Ground-glass nodules indicate the presence of mild infiltrates or inflammation in pulmonary nodules. Partial solid nodules are a mixture of ground-glass and solid nodules, which generally manifest as solid components appearing inside ground-glass nodules. In terms of composition alone, among the three, some solid nodules have the highest probability of change in follow-up, followed by ground-glass nodules, and solid nodules are relatively the smallest.
Second, look at the size.
A diameter of less than 5 mm is called a micronodule, a diameter of 5 mm-10 mm is called a small lung nodule, and a diameter of 11 mm-30 mm is called a lung nodule. In general, as the size of a pulmonary nodule increases, the probability of malignancy increases. Therefore, annual follow-up is recommended for micronodules smaller than 5 mmSmall lung nodules between 5 mm and 10 mm are recommended for 3-6 months follow-up examination. Benign nodules are considered if the nodule dissolves completely or tends to dissipate completely or tends to shrink after follow-up, and the nodule shrinks progressively or persistentlyIf solid nodules do not grow for more than 2 years, and ground-glass nodules do not grow for more than 3-5 years, the risk is reduced. If the nodule is enlarged, the margins are irregular, or the internal solid components are increased during the follow-up, it is necessary to be vigilant. Pulmonary nodules larger than 10 mm, especially those larger than 20 mm, should be immediately alarmed.
Partial solid nodules larger than 10 mm were pathologically early invasive adenocarcinoma after surgery.
3. Look at the form.
It is also important to focus on the medical radiologist's description of the pulmonary nodule. Benign is more likely if the following imaging signs are present, such as well-defined borders, smooth margins, uniform density, wide base of the contact surface with the pleura, and multiple small solid nodules under the pleura. Malignancy is more likely if there are the following imaging features, such as rough margins, burr signs, lobulation signs, pleural traction or depression signs, bronchial amputation, and vascular blood supply signs.
Bronchial amputation.
Fourth, combined with laboratory examinations.
Clinically, the changes in clinical markers of tumor markers such as gastrin-releasing peptide precursor (PROGRP), neur-specific enolase (NSE), carcinoembryonic antigen (CEA), squamous cell carcinoma antigen, and cytokeratin fragment 19 have certain reference significance for the diagnosis of lung cancer. Among them, gastrin-releasing peptide precursor (PROGRP) and neural-specific enolase (NSE) are helpful in the diagnosis of small cell lung cancerLung adenocarcinoma is usually accompanied by elevated carcinoembryonic antigen (CEA).Squamous cell carcinoma of the lung is often associated with elevated squamous cell carcinoma antigens.
5. Comprehensive analysis.
It is necessary to comprehensively analyze and consider one's own situation, including whether there are symptoms, smoking history, tumor history, family history, or whether there is any exposure to dust, asbestos, etc.
All in all, the evaluation of pulmonary nodules is diverse, including medical history, imaging tests, tumor marker examinations, and even functional imaging and some invasive examinations and surgeries to make the best judgment. Therefore, when a lung nodule is detected, timely medical attention and professional evaluation are key to ensure accurate classification and appropriate measures.
Contributed by: Zheng Chunhong |First trial: Hu Jianbo.
Text editor: Wang Xiaoyu |Proofreading Editor: Li Longhao.
Review: Shi Jiaping |Approved and released: Chen Guanlin.