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目的 探讨高分辨率CT(HRCT)在最大径≤1 cm肺实性小结节诊断中的应用价值.方法 回顾性分析23例最大径≤1 cm肺实性小结节的HRCT图像,包括结节最大径、形态、瘤-肺界面、结节密度特征、相对CT值等.采用两独立样本t检验对良、恶性小结节的最大径、相对CT值进行比较分析.良、恶性小结节的结节边缘及结节密度特征之间的比较采用Fisher精确概率法检验.结果 23例患者共检出最大径≤1 cm实性小结节24个,其中良、恶性分别为17个和7个.病灶呈圆形或卵圆形23个,不规则形1个.良、恶性肺实性小结节的最大径分别为(6.07±1.70)mm和(7.44±1.95)mm.17个良性小结节均表现为纯实性,瘤-肺界面光整锐利12个,边界模糊或毛刺征5个.7个恶性小结节中,6个表现为纯实性,另1个呈混杂密度影,瘤-肺界面光整6个,边缘短毛刺1个.良、恶性肺实性小结节的相对CT值分别为(-0.04±0.07)和(-0.08±0.06).良、恶性肺实性小结节的最大径、密度特征及边缘情况、相对CT值的差异均无统计学意义.结论 目前HRCT对最大径≤1 cm的肺实性小结节的良恶性鉴别诊断仍存在一定困难,需根据动态随访的变化情况予以判断.“,”Objective To investigate the value of HRCT in the diagnosis of pulmonary solid nodules less than 1 cm in diameter. Methods The HRCT features in 23 cases with pulmonary solid nodules less than 1 cm in diameter were analyzed retrospectively. The diameter, shape, tumor-lung interface, density and relative CT value were recorded and compared statistically. Results Totally 24 nodules were found in 23 cases, including 17 benign and 7 malignant nodules. The lesions presented as round-shape in 23 and irregular in 1. The diameter of benign and malignant nodules were (6.07±1.70) mm and (7.44±1.95) mm respectively. All 17 benign nodules were pure solid, with clear tumor-lung interface in 12 and unclear or glitches in 5. 6 malignant nodules showed as pure solid, while the other one was mixed density. The tumor-lung interface was clear in 6, and the other one presented glitches. The relative CT value of benign and malignant nodules were (-0.04±0.07) and (-0.08±0.06)respectively. There are no significant difference in the diameter, tumor-lung interface, density and relative CT value between benign and malignant nodules. Conclusion HRCT plays important role in the follow-up duration with pulmonary solid nodules less than 1 cm in diameter.