倍增时间的测定在肺小结节随访中的应用价值

目的评估倍增时间的测定在肺小结节病变随访中的应用价值。材料和方法初次胸部cT检查发现肺部小结节的病灶（直径？3cm）并有复查资料的患者共202例（确诊108例）。其中直径〈5mill组16例，5～10mm组38例，11～20ram组123侈4，21～30mm组25例：按照结节的密度：实质性结节127例，部分实性的结节65例，磨玻璃样结节10例。采用GELig11LSpeedPr016螺旋cT扫描，工作站为hW4．2的高级肺结节分析（AdvallcedLungAnalYSiS，ALA）数据后处理软件，重建肺结节体积并计算其倍增时间及生长率、并与最终临床结果作对照。结果磨玻璃样结节均重建失败，直径〈5mm的结节部分重建失败。艮性或炎性结节其生长速度非常快，倍增时间小于30天，或生长速度非常缓慢或负生长，倍增时间超过180天以上或者为负值。恶性结节倍增时间分别为腺癌136±2天，鳞癌89±7天，大细胞癌118±9天，小细胞癌35±4天，转移癌61±5天。结论在肺部小结节难以定性时，倍增时间可以作为定性诊断的重要指标。

The Application of Doubling Time in the Diagnosis of Following Up Lung Nodules

Objective To evaluate the application value of doubling time in lung nodules lesions in the following-up. Materials and Methods 202 patients （ 108 cases diagnosed） who were found the lung nodule lesions （〈 3 cm in diameter） by chest CT and had under- went CT scan at least twice. In all lesions, 16 cases in the group of diameter 〈 5ram, 38 cases in 5 - 10ram, 123 cases in 11 - 20ram and 25 cases in 21 - 30ram group. According to lhe density of nodes： 127 cases of substantial nodules, parl of the solid nodtdes 65 cases, ground glass opacity nodules 10 cases. Using the GE Lightspeed Pro l6 spiral CT and AW4.2 workstation, we reconstructed the lung nodules and calculated its w~lume doubling time with Advanced Lung Analysis software, taking the final clinical results as a control. Results Ground glass opacity sample nodules are all failed to reconstruct, and parts of nodules diameter 〈 5mm are also failed.Benign or inlqammatory nodules grow very fast, doubling time less than 30 days, or grow very slow or grow negatively, doubling time more than 180 days or as a negative value. Malignant nodules doubling time respectively for adenocarcinoma 136 ± 12 days, and squamous cell carcinoma 89 ± 7 days, large cell car- cinoma 118 ± 9 days, small cell carcinoma 35 ± 4 days, metastatic carcinoma 61 ＋ 5 days. Conclusion In the case when lung nodt, les are difficult to di~gnosis, doubling time can be used as an important index of qualitative diagnosis.