肺不典型腺瘤样增生与原位腺癌的多层螺旋CT征象对照分析  

Comparison Analysis of MSCT Between Atypical Adenomatous Hyperplasia and Adenocarcinoma in Situ of Lung

作　　者：邢彦粉 李振 魏生峰 孙希文[3] 

机构地区：[1]莱芜市中医医院,山东莱芜271100 [2]莱芜市妇幼保健医院,山东莱芜271100 [3]同济大学附属上海市肺科医院,上海200433

出　　处：《肿瘤学杂志》2014年第11期936-941,共6页Journal of Chinese Oncology

摘　　要：[目的]对不典型腺瘤样增生(AAH)与原位腺癌(AIS)的多层螺旋CT(MSCT)征象进行对照分析,以提高AAH和AIS的诊断水平。[方法]回顾性分析经病理证实的59例AAH和35例AIS的MSCT征象(病灶分布、大小、形状、边缘形态、内部结构及邻近结构改变),用卡方检验或Fisher确切概率法进行统计学分析。[结果]AAH和AIS的分布部位、范围、形状和瘤—肺界面差异均无统计学意义(χ2=4.092、1.283、0.000、0.170,P均>0.05)。纯磨玻璃结节(pGGN)和混合性磨玻璃结节(mGGN)的浅分叶征、细小毛刺征、空泡征差异有统计学意义(χ2=17.399、20.490、8.866和5.641、4.804、5.546,P均<0.05);组间支气管充气征、胸膜凹陷征、穿行血管形态改变差异无统计学意义(χ2=2.984、3.445、2.836和0.781、1.128、1.172,P均>0.05)。pGGN组AAH和AIS的大小差异无统计学意义(χ2=1.964,P>0.05),该组AAH和AIS的浅分叶征、细小毛刺征、胸膜凹陷征和穿行血管形态改变差异均有统计学意义(χ2=12.543、4.519、5.455、24.614,P均<0.05);mGGN组AAH和AIS的大小差异有统计学意义(χ2=7.201,P<0.05),该组AAH和AIS的浅分叶征、细小毛刺征、空泡征、支气管充气征、胸膜凹陷征差异均无统计学意义(χ2=3.061、2.667、2.030、0.672、0.875,P均>0.05),穿行血管形态学改变在AAH和AIS组间差异有统计学意义(χ2=12.255,P<0.05)。[结论]通过对AAH和AIS的MSCT征象对照分析,发现AAH和AIS的影像学征象差异具有一定的统计学意义,有助于两者的鉴别诊断。[Purpose ] To improve the diagnosis of atypical adenomatous hyperplasia （AAH） and adenocarcinoma in situ （AIS） by comparison analysis of imaging findings on MSCT of the two diseases. [Methods] We evaluated 59 cases of AAH and 35 cases of AIS confirmed by histopathology. Comparison of MSCT features as size, shape, margin,internal characteristics and adjacent structure of lesions were respectively analyzed. [Results ] No differences were found in location,distribution, shape and well-defined between AAH and AIS （Xz=4.092,1.283,0.000, 0.170;P〉0.05）. There were significant differences in lobulated, speculated and vacuole sign be- tween pGGN and mGGN （X2=17.399,20.490,8.866 and 5.641,4.804,5.546 ;P〈0.05）,while no difference was found in air bronchogram,pleural indentation sign and vascular morphological changes in the two groups（X2=2.984,3.445,2.836 and 0.781,1.128,1.172 ; P〉0.05）.ln the group of pGGN the size of AAH and AIS was found no difference （X2=l.964,P〉0.05）,while significant differences were found in lobulated, spiculation, pleural indentation sign and vascular morpho- logical changes between AAH and AIS （X2=12.543,4.519,5.455,24.614;P〈0.05）. In the group of mGGN the size of AAH and AIS was found significant difference（X2=7.201 ,P〈0.05）,while no differences were found in lobulated, spiculation,vacuole sign,air-bronchogram and pleural in- dentation sign（X2=3.061,2.667,2.030,0.672,0.875 ; P〉0.05）, only vascular morphological changes was found significant difference between AAH and AIS （X2=12.255,P〈0.05）.[Conclusion] The comparison analysis of AAH and AIS on MSCT findings shows that there are some significance differences between the two diseases, which can be helpful for the differential diagnosis.

关 键 词：硬币病变 肺 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]