Pulmonary nodule imaging

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Evaluation of Solitary Pulmonary Nodule

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Conventional radiography is the initial method of choice for the evaluation of solitary pulmonary nodule. The evaluation and risk assessment of solitary pulmonary nodule will depend on several characteristics, such as: size, growth, shape, margin, air bronchogram sign, and attenuation. Further evaluation of solitary pulmonary lung nodule, should include enhanced CT scan or MRI imaging. Other imaging studies include PET scanning, which may be useful as a staging modality, detection of occult disease, and malignancy assessment.

Imaging

Plain Radiograph

  • Conventional radiography is the initial method of choice for the evaluation of pulmonary nodule
  • Conventional chest radiograph may also be helpful in the diagnosis of pulmonary nodule

CT

Calcification

  • Diffuse
  • Central
  • Laminated
  • Popcorn

Size

  • Less than 4mm
  • Between 4mm and 7mm
  • Between 8mm and 20mm
  • More than 20mm

Growth

Shape

  • Polygonal
  • Circular

Margins

  • Lobulated or scalloped margins
  • Intermediate probability
  • Smooth margins
    Usually associated with a benign-likelihood

Attenuation

  • Solid with glass component
  • Malignancy rate of only 7%
  • Partly solid with ground glass component
  • Malignancy rate of 63%
  • Non-solid only ground-glass lesions
  • Malignancy rate of 18%.

Contrast enhancement




On CT, radiological signs of pulmonary nodule, include:

  • Corona radiata sign
  • Highly associated with malignancy
  • Air bronchogram sign
  • Non-specific sign

MRI

Gallery

Plain Radiograph

CT

MRI

References


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