肺局灶性磨玻璃样病变的放射学与组织学特性相关性研究  

Study of the Histological and Radiologic Characteristics of Pulmonary Focal Ground-Glass Opacity

作　　者：林均海[1] 姜华伟[1] 王文虎[1] 

机构地区：[1]威海市文登中心医院CT室,山东264400

出　　处：《放射学实践》2006年第7期667-669,共3页Radiologic Practice

摘　　要：目的:通过HRCT肺部扫描分析局灶性磨玻璃样病变(FGGO)的组织学与放射学特性,以探讨对这类病变的治疗标准。方法:本组病例包括直径≤20mm大小的FGGO37例。在HRCT随访数月后(平均3.4个月),如病变持续存在,经胸腔镜活检或肺叶切除后送病理诊断。结果:支气管肺泡癌(BAC)20例,腺癌9例,非典型腺瘤样增生(AAH)8例。29例恶性病例中,仅1例有淋巴结侵犯。其中15例含有实性成份和17例≥10mm的FGGO为恶性。FGGO的大小及放射学特性与病变恶性率高度相关。含有实性成份的FGGO恶性率为93.7%;直径≥10mm的FGGO恶性率为95%。结论:持续存在的直径≥10mm或含有实性成分的FGGO为早期腺癌或癌前病变的表现。因而,对持续存在的FGGO应早期活检定性,以指导治疗。Objective：Pulmonary focal ground-glass opacity （FGGO） has been detected increasingly by high resolution CT. The purpose of this study was to evaluate the histological and radiological characteristics of pulmonary FGGO in order to develop a referable standard for the treatment. Methods：Thirty-seven cases with pulmonary FGGO which were ≤20mm in size were studied. In the patients with persistence of pulmonary FGGO,after following-up for a period of several months （mean=3.4months） ,lung biopsy with thoracoscopy or lobectomy was performed consecutively for histopathology diagnosis. Results：The histological diagnoses of these 37 cases included bronchioloalveolar carcinoma （BAC） （n= 20）, adenocarcinoma （n=9） and atypical adenomatous hyperplasia （AAH） （n= 8）. Of the total 29 malignant lesions, only one case had lymph node metastases. 15 FGGO with solid components and 17 FGGO ≥10mm in size were proved as malignant. The rate of malignancy were highly correlated with the size and radiological characteristics,i, e. 93.7 % for pulmonary FGGO with solid components,95 % for FGGO ≥10mm in diameter. Conclusion： Persistent pulmonary FGGO with solid components or ≥10mm in size was an indicator of early adenocarcinoma or pre-malignant lesion. Lung biopsy should be performed in persistent FGGO for treatment guidance.

关 键 词：体层摄影术 X线计算机 肺肿瘤 局灶性磨玻璃样病变 

分 类 号：R816.4[医药卫生—放射医学]