摘要目的:探讨不同大小恶性实性肺结节（MSPNs）的计算机断层扫描（CT）成像特点及其随生长的变化规律。方法:纳入2016年1月至2019年12月在树兰（杭州）医院行手术治疗且经病理证实的周围型肺癌患者150例共151枚MSPNs。根据结节大小，将结节分为4组：直径≤1.0 cm组（21枚结节）、1.0 cm<直径≤1.5 cm组（40枚结节）、1.5 cm<直径≤2.0 cm组（48枚结节）、2.0 cm<直径≤3.0 cm组（42枚结节）。分析、比较4组MSPNs患者的临床特征和结节的CT影像学特点。结果:4组患者的年龄、性别、吸烟史、既往肿瘤史、肿瘤家族史、临床症状、肺癌组织病理学类型方面的差异无统计学意义（ P>0.05）。4组MSPNs中，CT影像显示大多数结节位于两肺上叶，不靠近胸膜且瘤肺边界粗糙。随着MSPNs直径的增大，形状规则（圆形或椭圆形）、密度均匀、空气支气管征、分叶征、毛刺征、血管集束征、胸膜牵拉征的结节比例增加（ P<0.05），4组间钙化、空泡征、空洞、晕征发生率的差异无统计学意义（ P>0.05）。 结论:不同大小的MSPNs在CT影像上的表现有一定的规律性，这些规律可为临床早期诊断恶性结节提供帮助。

abstractsObjective:To investigate the CT imaging features and the variation patterns of malignant solid pulmonary nodules（MSPNs）in different sizes.Methods:We studied 151 MSPNs of 150 patients with peripheral lung cancer confirmed by surgery and pathology between January 2016 and December 2019. According to their sizes，the nodules were divided into four groups：Group A（21 nodules，diameter ≤ 1.0 cm）；Group B（40 nodules，1.0 cm < diameter ≤ 1.5 cm）；Group C（48 nodules，1.5 cm < diameter ≤ 2.0 cm）；Group D（42 nodules，2.0 cm < diameter ≤ 3.0 cm）. We compared and analyzed the clinical and CT imaging features of the four groups.Results:Most MSPNs in the four groups were located in the upper lobes of the lung，not attached to the pleura and having irregular margins. As the MSPNs increased in diameter，the proportion of regular shapes（round or oval），homogeneous density，air bronchogram sign，lobulation sign，spiculation sign，vascular convergence sign，and pleural retraction sign in the nodules increased significantly（ P < 0.05）. Yet the proportion of calcification，bronchus encapsulated air sign，cavities，and halo sign did not vary significantly among the four groups（ P > 0.05）. Conclusions:The CT imaging features of the MSPNs varied as they grew and the variations followed certain patterns. The knowledge of the variation patterns helps early clinical diagnosis of malignant nodules.