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首页> 外文期刊>Radiology >Lung cancers missed at low-dose helical CT screening in a general population: comparison of clinical, histopathologic, and imaging findings.
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Lung cancers missed at low-dose helical CT screening in a general population: comparison of clinical, histopathologic, and imaging findings.

机译：在一般人群中，低剂量螺旋CT筛查并未发现肺癌：临床，组织病理学和影像学检查结果的比较。

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PURPOSE: To compare clinical, histopathologic, and imaging features of lung cancers missed at low-radiation-dose helical computed tomography (CT). MATERIALS AND METHODS: Eighty-three primary lung cancers were found during an annual low-dose CT screening program and confirmed histopathologically at either surgery or biopsy. Thirty-two of these lung cancers were missed on 39 CT scans: on 23 scans owing to detection errors and on 16 owing to interpretation errors. The clinical characteristics, CT features, and histopathologic findings of these missed lung cancers were correlated. RESULTS: All missed cancers were intrapulmonary, and 28 (88%) were stage IA. All 20 detection errors occurred in cases of adenocarcinoma, 17 (85%) of which were well-differentiated tumors and 11 (55%) of which were in nonsmoking women. The mean size of cancers missed owing to detection error, 9.8 mm, was smaller than that of cancers missed owing to interpretation error, 15.9 mm (P <.001). In the detection error group, the percentages of nodules with ground-glass opacity (91%) or judged to be subtle (91%) were greater than those of nodules in the interpretation error group (38% and 25%, respectively) (P <.001). In the detection error group, 83% (19/23) of cancers were overlapped with, obscured by, or similar in appearance to normal structures such as pulmonary vessels. On 14 of the 16 CT scans with which there were interpretation errors, the CT findings mimicked benign disease, and the patients also had underlying lung disease, such as tuberculosis, emphysema, or lung fibrosis. CONCLUSION: The lung cancers missed at low-dose CT screening in this series generally were very subtle and appeared as small faint nodules, overlapping normal structures, or opacities in a complex background of other disease.
机译：目的：比较低剂量螺旋计算机断层扫描（CT）漏诊的肺癌的临床，组织病理学和影像学特征。材料与方法：在每年的低剂量CT筛查程序中发现了83例原发性肺癌，并在手术或活检中得到了组织病理学证实。其中39例CT扫描漏检了其中的32例肺癌：由于检测错误而漏检23例，由于解释错误而漏诊16例。这些漏诊的肺癌的临床特征，CT特征和组织病理学发现是相关的。结果：所有漏诊的癌症均为肺内癌，其中28例（88％）为IA期。所有20个检测错误均发生在腺癌病例中，其中17个（85％）是高分化肿瘤，其中11个（55％）是非吸烟女性。由于检测错误而遗漏的癌症的平均大小为9.8毫米，比由于解释错误而遗漏的癌症的平均大小为15.9毫米（P <.001）。在检测误差组中，毛玻璃样不透明结节的百分比（91％）或被判断为细微的结节（91％）大于解释误差组的结节（分别为38％和25％）（P <.001）。在检测错误组中，有83％（19/23）的癌症与正常结构（如肺血管）重叠，被其遮盖或类似。在16项CT扫描中有14项存在解释错误时，CT表现模仿了良性疾病，并且患者还患有潜在的肺部疾病，例如肺结核，肺气肿或肺纤维化。结论：本系列低剂量CT筛查漏诊的肺癌通常非常微妙，表现为细小的结节，正常结构重叠或在其他疾病的复杂背景下混浊。

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