小肺癌SCT漏／误诊5例CT征像分析

目的：确定初次SCT漏／误诊而后CT扫描检测到的小肺癌CT征象。材料与方法：复习2490例初次SCT普查中漏／误诊患者的CT征象，回顾性评价其CT征象、检测时间、细胞类型及病理分期。结果：初次SCT扫描漏误诊小肺癌5例，其中4例病检肺癌为1期，1例为Ⅱ期。结论：SCT普查可漏／误诊接近检测阈的小肺癌结节，慎用双窗观察，推荐随访检查。

Missed Detection and Failures Diagnosis in Spiral CT Screening for Iung Cancer: Analysis of CT Findings of 5 Cases

Purpose： To clarify the computed tomographic （ CT findings and the progrssion of minute lung cancers that missed or failured diagnosis at initial spiral CT screening but were later detected. Materials and Methods： The findings from five patients with lung cancer that was missed or failured diagnosis at the initial spiral CT screening were reviewed. Retrospective CT findings, time to detection, cell type, and pathologic stage were evaluated. Results： Minute lung cancers missed or failured diagnosis at early spiral CT included a nodule among the shadows of old tuberculosis（ n = 1 ）, a faint nodule with high attenuation in the center of the nodule（ n = 1）, an increase in attenuation just adjacent to an axial peripheral pulmonary vessel （ n = 1） and adjacent to a eranioeaudal peripheral pulmonary vessel（ n = 1）, and a minute faint nodul（ n = 1）. The time to detection ranged from 6 -18 months. At pathologic examination, four cancers were stage Ⅰ, and on -were stage Ⅱ. Conclusion： Minute nodules of lung cancer that may be missed or failured diagnosis at spiral CT screening. It is important to examine noncalcified nodules with high resolution CT（HRCT） even when lesions from prior diseases, such as those from old tuberculosis, exist and to evaluate the ＇shadows of pulmonary vessels carefully A follow - up examination is highly recommended.