孤立性肺结节：良性与恶性对比.

Relationship between SPN-size and chance of malignancy in patients with high risk for lung cancer 结节大小与恶性度具有密切相关性
Growth 生长速度

Comparison with prior imaging studies is often the most useful procedure to determine the importance of the finding of a SPN, since stability over 2 years is highly associated with benignity.
弥漫性，中心性，分层，爆米花钙化是良性 钙化，


These types of calcification are seen in granulomatous disease and hamartomas
这些形式的钙化最常见于错构瘤、肉芽肿 性病变



The exception to the rule above is when patients are known to have a primary tumor. For instance the diffuse calcification pattern can be seen in patients with osteosarcoma or chondrosarcoma. Similarly the central and popcorn pattern can be seen in patients with GI-tumors and patients who previously had chemotherapy. 一些病人有原发肿瘤病史，可以表现为良性钙化 例如骨肉瘤、软骨肉瘤可以表现弥漫性钙化。 胃肠间质瘤的病人化疗后可以表现为中心性或苞米 花钙化。
Solitary pulmonary nodule: benign versus malignant 孤立性肺结节：良性与恶 性对比



The differential diagnosis of a solitary pulmonary nodule is broad and management depends on whether the lesion is benign or malignant. 孤立性肺结节的鉴别诊断是很多的，处理方法依 赖于该病变是良性还是恶性 In this overview we will discuss some of the new features that can help to differentiate between benign and malignant nodules based upon CT and PET-CT findings. 在此篇文章，我们着重讨论下一些有助于鉴别良 恶性结节的新特征，此特征是基于CT与PET-CT的 检查结果
与前次影像结果相比是鉴别孤立性结节良 恶性的一个非常有用的方法。如果超过2年 以上保持不变，这个结节就是良性结节

Shape 形态



Japanese screening studies showed that a polygonal shape and a three-dimensional ratio > 1.78 was a sign of benignity (2,3). 日本的一项研究表明，多变形和三维立体比率大 于1.78是良性结节的标志 A polygonal shape means that the lesion has multiple facets (multi-sided). 多边形意味这个病灶具有多个面A peripheral subpleural location was also a sign of benignity in this study 在这项研究中，周围的胸膜下的病变也是良性结 节的一个标志
CT:良性与恶性



钙化 大小 生长速度 形状 边缘 支气管含气征 实性或磨玻璃样 增强特征
Calcification 钙化

Diffuse, central, laminated or popcorn calcifications are benign patterns of calcification.
CT: benign versus malignant

Calcification Size Growth Shape Margin Air Bronchogram sign Solid and Ground-glass components Contrast enhancement

The three-dimensional ratio is measured by obtaining the maximal transverse dimension and dividing it by the maximal vertical dimension. A large three-dimensional ratio indicates that the lesion is relatively flat, which is a benign sign.
Size 大小

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A solitary pulmonary nodule (SPN) is defined as a single intraparenchymal lesion less than 3 cm in size and not associated with atelectasis or lymphadenopathy. A lesion greater than 3 cm in diameter is called a mass. 孤立性结节定义为小于3cm，不伴有肺不张、淋巴 结转移，大于3cm的为肿块 This distinction is made, because lesions greater than 3 cm are usually malignant, while smaller lesions can be either benign or malignant. 以3cm为界，因为大于3cm的通常是恶性的，而小 于3cm的可能是良性或恶性。