经HRCT探讨肺磨玻璃结节与血管的关系  

HRCT study of the relationships between pulmonary ground glass nodules and blood vessels

作　　者：郑葵葵[1] 周晓璇[2] 徐浩力 陈伟建[1] 杨运俊[1] 

机构地区：[1]浙江省温州医科大学附属第一医院放射影像中心,浙江温州325000 [2]浙江省温州医科大学,浙江温州325000

出　　处：《医学影像学杂志》2016年第3期431-434,共4页Journal of Medical Imaging

基　　金：浙江省温州科技对外合作项目(H20090012)

摘　　要：目的：研究肺磨玻璃结节（ ground glass nodule ， GGN）与血管的关系及其分型，并探讨其诊断价值。方法对58例GGN患者（其中2例患者有2个GGN）的HRCT影像进行回顾性分析。根据GGN与周围血管的关系分3型：Ⅰ型，血管清晰穿过和／或紧邻GGN；Ⅱ型，血管在GGN内扭曲和／或扩张；Ⅲ型，GGN内血管截断和／或合并以上的形态。分析此分型与GGN病理之间的相关性。结果58例GGN患者中，病理证实良性病变11个、浸润前病变26个、浸润性病变23个。Ⅰ型、Ⅱ型和Ⅲ型的GGN分别为13、23和24个。各型血管关系在不同性质的GGN中显示的差异有明显统计学意义（χ2＝17．92， P ＝0．01）。 GGN血管Ⅱ型、Ⅲ型合并，浸润性病变组、浸润前组及良性组各有22个（96％，22／23），21个（81％，21／26），4个（36％，4／11），血管表现为异常时，恶性的可能性越大，3组GGN与血管是否正常存在相关性（ r ＝0．462， P ＜0．01）。结论不同类型GGN与血管的不同关系有助于GGN的定性诊断。Objective To investigate the relationships between pulmonary ground glass nodules （GGN） and blood vessels, and to explore the diagnostic values in differentiating GGNs .Methods HRCT imaging of 58 patients （60 GGNs） was retrospec-tively reviewed .Relationships between GGNs and supplying blood vessels were categorized into three types ：I, intact vessels pass-ing through and/or passing by GGNs;II, dilated, distorted and/or dilated seen within GGNs;III, interrupted seen within GGNs or/and more complicated vasculature than described above .Relationship types were correlated to pathologic findings of GGNs . Results Of 58 patients, 11 were benign, 26 were preinvasive disease and 23 were invasive disease that were pathologically prov-en.Types I, II and III vascular relationships were observed in 13, 23 and 22 GGNs, respectively.A significant statistical differ-ence was shown between GGN-vessel relationships and groups （χ2 =17.92, P =0.01）.Combined type III and III ＋IV, 22 were invasive disease （96%,22/23）, 21 were preinvasive disease （81%,21/26） and 4 were benign （36%,4/11）.When GGN-vessel appeared abnormal , the higher risk of GGN should be malignant .Correlation analysis showed correlation between groups and relationships .Conclusion Different GGNs have different relationships with vessels that may help to identify which GGNS are more likely to be malignant .

关 键 词：血管 磨玻璃结节 体层摄影术 X线计算机 腺癌 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]