Abstract:

Objective    To evaluate the relationship between solitary pulmonary nodule (SPN) and bronchus and its value in predicting the nature of nodule. Methods    66 SPN cases (29 benign and 37 malignant tumors) with clear diagnosis were retrospectively studied, All patients were scanned by multi-slice spiral computed tomography ( MSCT) and the images were reformed by multi-planar reformation(MPR) in the workstation to show SPNbronchus relationship from various angles. SPN- bronchus relationship was analyzed and compared with the examination result of microscopic specimens. Results    The SPN and bronchus was related in 51 of the 66 cases, including 18 (62.1%) benign nodules and 33 (89.2%) malignant nodules. There was a significant difference bwteen the benign and malignant groups (P＜0.01). The SPNbronchus relationship was identified as five types: typeⅠ: the bronchus was abruptly obstructed at the edge of SPN; typeⅡ: the bronchus penetrated into SPN with tapered narrow and interruption; type Ⅲ: the bronchus ran through the whole SPN; typeⅣ: the bronchus ran at the periphery of SPN; and typeⅤ: the bronchus converged on the SPN. The SPN-bronchus relationship in most malignant nodules belonged to typesⅡ,Ⅲ and Ⅴ. TypesⅡ and Ⅲ was more showed in adenocarcinoma. There was a significant difference between malignant and benign tumors in typesⅡand typeⅤ(P＜0.01). Conclusion    MSCT volume scan and MPR can clearly show the relationship between the SPN and bronchus, and the relationship is valuable in determining the nature of differentiation of SPN. Certain patterns of SPN- bronchus may reflect definite pathologic changes of SPN.

Key words:  Coin lesion, pulmonary; Bronchi; Tomography, Xray computed; Pathology