The value of MSCT in the diagnosis and differential diagnosis of pleural indentation of solitary pulmonary nodules (≤ 2cm)

CAO Hanbo; WANG Mei; WANG Heping

Abstract：Objective To investigate the value of MSCT in the diagnosis and differential diagnosis of pleural indentation of solitary pulmonary nodules (≤ 2 cm).Methods 20 patients with early peripheral lung cancer and 16 patients with benign nodules,who were all confirmed by surgical pathology or biopsy,were analyzed.Through target reconstruction,minimum intensity projection (MIP),shaded surface display (SSD),and volume rendering (VR) after treatment,the lesions of pleural indentation were revealed.And then,the pleural indentation signs were divided into type Ⅰ,type Ⅱ and type Ⅲ,and the differences in types between the benign nodules and early peripheral lung cancer were compared.Results In type Ⅰ,7 cases presented with pleural indentation sign,of which 2 cases were benign nodules and 5 cases were malignant nodules.In type Ⅱ,18 cases presented with pleural indentation sign,of which 6 cases were benign nodules and 12 cases were malignant nodules.In type Ⅲ,11 cases presented with pleural indentation sign,of which 8 cases were benign nodules and 3 cases were malignant nodules.On SSD images,2cases of benign nodules and 4 cases of early lung cancer presented with mild pleural indentation.4 cases of benign nodules and 12cases of early lung adenocarcinoma presented with pleural indentation signs,which were like stellate change and a plurality of grooves with distortion and variation of length and the thickness were seen around the lesions.The local hypertrophic pleura were seen in 12 cases of benign nodules and 3 cases of early lung cancer.The differences in target reconstruction and MIP type and SSD pleural indentation types between benign nodules and early lung adenocarcinoma were statistically significant (P ＜ 0.05).The pleural indentation signs in benign pleura1 nodules mainly appeared in type Ⅱ and Ⅲ and the rate of local hypertrophic pleura was significantly higher than that of early lung adenocarcinoma (P ＜ 0.001).Conclusion MSCT target reconstruction combined with various post-processing functions has a unique advantage in the diagnosis of small solitary pulmonary nodules,which provides a reference for the qualitative diagnosis of benign and malignant pulmonary nodules.