医学孤立性肺结节petct良恶性鉴别诊断.pptVIP

;孤立性肺结节的鉴别诊断，在临床中经常遇到。根据结节的良恶性差异，处理方法有很大差别。在这篇文章中，我们主要探讨CT和PET-CT的相关征象在孤立性肺结节良恶性鉴别诊断中的意义。;目录（contents）;钙化;Calcification;结节大小;Size ;生长速度;Growth;形状;Shape;边缘;Margin;充气支气管征;Air Bronchogram sign;图中两个SPN，根据形态表现，哪个更像恶性的？ 左边的结节边缘呈毛刺状，内部有透亮区；右侧者呈分叶状，边缘毛刺并与胸膜粘连，但是内部均质。 基于上面的表现，我们认为左侧者更像恶性的。最终证实，左侧者为腺癌，右侧为真菌感染。;On the left two solitary pulmonary nodules.Based upon the morphology, which lesion has the most malignant features? The lesion on the far left has a spicuated margin and has lucencies within it. The lesion next to it is lobulated in contour and has some spicules radiating to the pleura.It is however homogeneous in attenuation.Based on these findings we should be most concerned that the lesion on the far left is malignant.It proved to be an adenocarcinoma, while the other one was a fungal infection.The lucencies and frank air bronchograms should not mislead you in thinking that it probably is infection. ;实性和磨玻璃成分;Solid and Ground-glass components;左侧者只有磨玻璃成分；右侧者既有磨玻璃成分又含有实性成分。 左侧者恶性可能性为1/5;右侧者恶性可能性为2/3.;On the far left a lesion that only has a ground-glass appearance and next to it a lesion that has both ground-glass and solid components.The likelihood of malignancy is 1:5 for the lesion on the far left and 2:3 for the lesion with both ground-glass and solid components.;强化特征;Contrast enhancement ;PET-CT;PET-CT: benign versus malignant ;结论;Conclusion