{"title":"形态学显示为恶性的炎性肺实性结节的临床和计算机断层扫描特征","authors":"Wei-Hua Zhao, Li-Juan Zhang, Xian Li, Tian-You Luo, Fa-Jin Lv, Qi Li","doi":"10.1016/j.acra.2024.09.016","DOIUrl":null,"url":null,"abstract":"<p><strong>Rationale and objectives: </strong>To investigate the clinical and computed tomography characteristics of inflammatory solid pulmonary nodules (SPNs) with morphology suggesting malignancy, hereinafter referred to as atypical inflammatory SPNs (AI-SPNs).</p><p><strong>Materials and methods: </strong>The CT data of 515 patients with SPNs who underwent surgical resection were retrospectively analyzed. These patients were divided into inflammatory and malignant groups and their clinical and imaging features were compared. Binary logistic regression analysis was performed to identify the independent factors for diagnosing AI-SPNs. An external validation cohort included 133 consecutive patients to test the model's predictive efficiency.</p><p><strong>Results: </strong>Univariate analysis showed that age < 62 years, male sex, maximum spiculation length > 9 mm, polygonal shapes, three-planar ratio > 1.48, Lung window/mediastinal window (L/M) ratio > 1.13, pleural tag type I, satellite lesions, and halo sign were more frequent in AI-SPNs, whereas pleural tag type III, bronchial truncation, and perifocal fibrosis were more common in malignant SPNs (M-SPNs) (all P < 0.05). Binary logistic regression showed age < 62 years, male sex, polygonal shape, three-planar ratio > 1.48, L/M ratio > 1.13, pleural tag type I, satellite lesions, halo sign, and absence of bronchial truncation were independent factors for diagnosing AI-SPNs (AUC, sensitivity, specificity, and accuracy of 0.951, 83.30%, 92.30%, and 87.20%, respectively). In the external validation cohort, the AUC, sensitivity, specificity, and accuracy were 0.969, 90.47%, 90.00%, and 90.23%, respectively.</p><p><strong>Conclusion: </strong>AI-SPNs and M-SPNs exhibited different clinical and imaging characteristics. A good understanding of these differences may help reduce diagnostic errors in AI-SPNs and enable to choose an optimal treatment strategy.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical and Computed Tomography Characteristics of Inflammatory Solid Pulmonary Nodules with Morphology Suggesting Malignancy.\",\"authors\":\"Wei-Hua Zhao, Li-Juan Zhang, Xian Li, Tian-You Luo, Fa-Jin Lv, Qi Li\",\"doi\":\"10.1016/j.acra.2024.09.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Rationale and objectives: </strong>To investigate the clinical and computed tomography characteristics of inflammatory solid pulmonary nodules (SPNs) with morphology suggesting malignancy, hereinafter referred to as atypical inflammatory SPNs (AI-SPNs).</p><p><strong>Materials and methods: </strong>The CT data of 515 patients with SPNs who underwent surgical resection were retrospectively analyzed. These patients were divided into inflammatory and malignant groups and their clinical and imaging features were compared. Binary logistic regression analysis was performed to identify the independent factors for diagnosing AI-SPNs. An external validation cohort included 133 consecutive patients to test the model's predictive efficiency.</p><p><strong>Results: </strong>Univariate analysis showed that age < 62 years, male sex, maximum spiculation length > 9 mm, polygonal shapes, three-planar ratio > 1.48, Lung window/mediastinal window (L/M) ratio > 1.13, pleural tag type I, satellite lesions, and halo sign were more frequent in AI-SPNs, whereas pleural tag type III, bronchial truncation, and perifocal fibrosis were more common in malignant SPNs (M-SPNs) (all P < 0.05). Binary logistic regression showed age < 62 years, male sex, polygonal shape, three-planar ratio > 1.48, L/M ratio > 1.13, pleural tag type I, satellite lesions, halo sign, and absence of bronchial truncation were independent factors for diagnosing AI-SPNs (AUC, sensitivity, specificity, and accuracy of 0.951, 83.30%, 92.30%, and 87.20%, respectively). In the external validation cohort, the AUC, sensitivity, specificity, and accuracy were 0.969, 90.47%, 90.00%, and 90.23%, respectively.</p><p><strong>Conclusion: </strong>AI-SPNs and M-SPNs exhibited different clinical and imaging characteristics. A good understanding of these differences may help reduce diagnostic errors in AI-SPNs and enable to choose an optimal treatment strategy.</p>\",\"PeriodicalId\":50928,\"journal\":{\"name\":\"Academic Radiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-09-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Academic Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.acra.2024.09.016\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.acra.2024.09.016","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Clinical and Computed Tomography Characteristics of Inflammatory Solid Pulmonary Nodules with Morphology Suggesting Malignancy.
Rationale and objectives: To investigate the clinical and computed tomography characteristics of inflammatory solid pulmonary nodules (SPNs) with morphology suggesting malignancy, hereinafter referred to as atypical inflammatory SPNs (AI-SPNs).
Materials and methods: The CT data of 515 patients with SPNs who underwent surgical resection were retrospectively analyzed. These patients were divided into inflammatory and malignant groups and their clinical and imaging features were compared. Binary logistic regression analysis was performed to identify the independent factors for diagnosing AI-SPNs. An external validation cohort included 133 consecutive patients to test the model's predictive efficiency.
Results: Univariate analysis showed that age < 62 years, male sex, maximum spiculation length > 9 mm, polygonal shapes, three-planar ratio > 1.48, Lung window/mediastinal window (L/M) ratio > 1.13, pleural tag type I, satellite lesions, and halo sign were more frequent in AI-SPNs, whereas pleural tag type III, bronchial truncation, and perifocal fibrosis were more common in malignant SPNs (M-SPNs) (all P < 0.05). Binary logistic regression showed age < 62 years, male sex, polygonal shape, three-planar ratio > 1.48, L/M ratio > 1.13, pleural tag type I, satellite lesions, halo sign, and absence of bronchial truncation were independent factors for diagnosing AI-SPNs (AUC, sensitivity, specificity, and accuracy of 0.951, 83.30%, 92.30%, and 87.20%, respectively). In the external validation cohort, the AUC, sensitivity, specificity, and accuracy were 0.969, 90.47%, 90.00%, and 90.23%, respectively.
Conclusion: AI-SPNs and M-SPNs exhibited different clinical and imaging characteristics. A good understanding of these differences may help reduce diagnostic errors in AI-SPNs and enable to choose an optimal treatment strategy.
期刊介绍:
Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.