表现为纯磨玻璃影的原位腺癌及微浸润腺癌CT鉴别诊断  

Differentiation between adenocarcinoma in situ and minimally invasive adenocarcinoma in CT menifestied as pure ground-glass nodules

作　　者：范艳芬[1] 王梅[1] 曹捍波[1] 张善华[1] 王善军[1] 王兆宇[2] 张永奎[3] 

机构地区：[1]浙江省舟山医院放射科,浙江舟山316004 [2]浙江省舟山医院病理科,浙江舟山316004 [3]浙江省舟山医院胸外科,浙江舟山316004

出　　处：《中国现代医生》2015年第34期107-110,F0003,共5页China Modern Doctor

基　　金：国家卫生和计划生育委员会科研基金(WKJ2014-2-021)

摘　　要：目的探讨表现为纯磨玻璃结节影(pure ground-glass nodules,p GGONs)的原位腺癌(adenocarcinoma in situ,AIS)及微浸润腺癌(minimally invasive adenocarcinoma,MIA)的不同CT特征及二者之间的鉴别诊断。方法回顾性分析CT表现为p GGONs并且经手术后病理证实的76例AIS、26例MIA的术前CT及临床资料,CT特征包括病灶最大径、平均CT值、病灶的形态、穿过病灶的血管走行、空气支气管征。结果AIS组的平均CT值为(-668.5±76.4)HU,MIA组的CT值为(-595.58±120.20)HU,两者比较差异有统计学意义;AIS组的最大径约(0.80±0.34)cm,MIA组的最大径约(1.20±0.43)cm,差异有统计学意义(P<0.01);两组结节形态、穿过结节的血管走行之间的差异有统计学意义;而两组空泡征之间的差异无统计学意义;利用结节的最大径、平均CT值及穿过结节的血管走行联合判断结节的病理类型,可以更好提高诊断价值。结论应用结节的最大径、平均CT值及穿过结节的血管走行可以鉴别表现为p GGONs的AIS及MIA。Objective To study the computed tomography features of patients of pure ground-glass nodules（GGONs） to distinguish AIS from MIA. Methods 76 AIS and 26 MIA were proved by surgery and pathology underwent CT scan before treament. CT characteristics of these p GGNs and pathological grading were analyzed retrospectively,CT manifestations including lesion maximum diameter, average CT attenuation,shapes,leision vesseles,air-containing. Results The average CT attenuation of the AIS were（-668.5±76.4）HU,the average CT attenuation of the MIA were（-595.58±120.20）HU;the maximum diameter of AIS were（0.80±0.34）cm, the maximum diameter of MIA were（1.20±0.43）cm;There was obvious difference between the two groups（P〈0.01）, with statistical significance. There were statistically significant in lesion shapes, lesion vessels. There were no statistically significant in air-containing. Combining the average CT attenuation,the maximum diameter, lesion vesseles,we can diagnose accuraty. Conclusion With the average CT attenuation,the maximum diameter, lesion vesseles, the MIA and AIS could be dintinguished.

关 键 词：肺腺癌 磨玻璃影 原位腺癌 微浸润腺癌 病理学 

分 类 号：R730.44[医药卫生—肿瘤] R734.2[医药卫生—临床医学]