CT morphological analysis and changes of lymph nodes in pulmonary inflammatory pseudotumor of different sizes

LI Xiaoran; QIAO Xiangmei; FU Xiaoming; ZHU Wenli; ZHOU Kefeng

Abstract：Objective To investigate the morphological characteristics and lymph node changes in pulmonary inflammatory pseudotumor(PIP)of different sizes on computed tomography(CT).Methods A total of 56 patients identified as histopatho-logical PIP were retrospectively collected,and divided into two groups according to the size of the lesions:the maximum diameter≤3cm group(34 cases)and the maximum diameter>3cm group(22 cases).The differences in CT imaging characteristics and lymph node manifestations between the two groups were analyzed and compared.Intraclass correlation coefficient(ICC)and kappa test were used to evaluate the consistency of data between two radiologists,and the Bland-Altman method was used to fur-ther visualize the consistency measurement results.Results There were significant differences in bronchovascular bundle thick-ening,peach-tip sign,vascular convergence sign,adjacent pleural thickening,and lymphadenectasis between the two groups(P<0.05),and the above signs were more common in the group with maximum diameter>3cm.Further comparison of lymph nodes between the two groups revealed that ipsilateral hilar lymph nodes(P<0.05)were more likely visible to the unaided eyes in the maximum diameter>3cm group,and the size was significantly larger than that in the maximum diameter≤3cm group.The consis-tency of PIP related data measured by two radiologists was good or excellent(ICC and Kappa ranged from 0.61 to 0.85).Bland-Altman analysis showed that the consistency and stability of lymph node diameter were good.Conclusion PIP of different sizes has certain differences in CT manifestations,which is helpful for radiologists and clinicians to understand this disease more deeply and to reduce misdiagnosis.