Chest Radiographic Findings of Missed Lung Cancers

判讀遺漏的肺癌之胸部X光素片表徵

林吉晉(Gigin Lin) ； 高常發(Sheung-Fat Ko) ； 張潤忠(Yun-Chung Cheung) ； 饒啟明(Kee-Min Yeow) ； 吳樹鏗(Shu-Hang Ng)

《中華放射線醫學雜誌》 29卷6期 (2004/12) Pp. 315-321

摘要

評估判讀遺漏的肺癌之胸部X光素片表徵。
本研究針對從2002到2003年，37例最初胸部X光素片未診斷出的肺癌病例。其組織型皆為非小細胞癌。回顧胸部X光素片上病灶大小、位置、表現形態，以及重疊的構造。
685位肺癌病患中有37例(5.3%)在最初胸部X光素片未診斷出來。男性有28例(76%)，女性有9例(24%)。病患平均年齡為68.11歲。病灶平均大小為2.1公分。最多在肺上葉(46%)，其次為下葉(38%)及中葉(16%)。大多數位於中央部位(81%)，而少數位於肺周邊(19%)。節結腫塊表現的病灶佔68%，以肺阻塞癱塌的佔27%，而肺門腫大佔46%。所有的病灶都有解剖構造阻檔。
熟悉判讀遺漏的肺癌之胸部X光素片表徵可幫助察覺肺癌病灶。

關鍵字

判讀 ； 肺腫瘤 ； 胸部X光素片

並列摘要

To assess the failure of detection of lung cancer at chest radiography.
From 2002 to 2003, we collected 37 cases of lung cancer that were initially undetected but were diagnosed retrospectively at chest radiography. Of these 37 cases, 17 were adenocarcinoma, 15 were squamous cell carcinoma and the other 5 were non-small cell carcinoma. Size, locations, and patterns of the missed tumors as well as the superimposed structures at chest radiography were reviewed.
Lung cancers were missed at chest radiography in 37 of 685 (5.3%) patients, of whom 28 (76%) were men and 9 (24%) were women. The median patient age was 71 years. The mean diameter of the missed cancers was 2.1cm. Most of the missed cancers (81%) were centrally located. In respects of lobar distribution of the missed lesions, 46% of the lesion was in the upper lobe, 38% in the lower lobe and 16% in the middle lobe. The majority of the missed cancers presented either as a nodular, ill-defined, or hypodense lesion. In all our 37 cases, the lesions were obscured at least in part by the superimposed structures, particularly the ribs and pulmonary vessels.
Well recognition of the characteristics of missed lung cancer may help in the way of tumor detection.

並列關鍵字

Diagnosis radiology, observer performance ； Lung neoplasms, diagnosis ； Thorax, radiology