肺内亚实性结节的CT表现与病理相关性研究

Correlation Study between CT Manifestations and Pathological Features of Subsolid Pulmonary Nodules

摘要: 亚实性结节作为肺癌早期筛查的关键影像学表现，其诊断与治疗策略高度依赖CT技术，并与肺腺癌的病理特征密切相关。然而，由于目前肺结节在诊断中的阳性判断标准不一、成像参数存在差异，以及病理表现与影像特征之间的不一致，导致不同地区对同一病例的处理意见往往大相径庭。针对上述问题，本文系统综述了常规CT技术与新兴技术在亚实性结节良恶性鉴别中的应用现状与发展趋势。常规CT中，低剂量CT (LDCT)需结合特定人群调整判定阈值(如中国人群建议≥8 mm)，双能量CT (DECT)有助于提升结节血供显示能力，而PET-CT主要用于确诊后的分期与治疗评估。新兴技术如人工智能与影像组学则通过将影像特征转化为定量数据，构建预测模型，以识别人眼难以察觉的细微特征。此外，本文还概述了肺结节的自然病程，并对比分析了不同国际指南在处理建议方面的异同。

Abstract: Subsolid nodules represent a critical imaging manifestation in early lung cancer screening, with their diagnosis and management being highly dependent on CT equipment and closely correlated with the pathology of lung adenocarcinoma. Current challenges in pulmonary nodule evaluation include inconsistent positive judgment criteria and variability in imaging parameters. To address these issues, this article systematically reviews the application of different CT technologies and emerging techniques in the differentiation of benign and malignant SSNs. In conventional CT, low-dose CT (LDCT) requires population-adjusted thresholds (e.g., optimized to ≥8 mm for Chinese populations), while dual-energy CT (DECT) enhances the visualization of nodular blood supply. PET-CT is primarily utilized for staging and treatment planning post-diagnosis. Emerging technologies such as artificial intelligence and radiomics facilitate the quantification of visual data, enabling the development of models that detect details imperceptible to the human eye. Finally, this review outlines the natural course of pulmonary nodules and compares the similarities and differences in management recommendations among international guidelines.