纯磨玻璃密度肺腺癌病灶内部CT影像特点  

Internal CT imaging features of lung adenocarcinoma presented as pure ground-glass opacity

作　　者：左玉强[1] 冯平勇[2] 孟庆春[1] 左晓玲[1] 田云霞[1] 王黎[2] ZUO Yu- qiang FENG Pingyong MENG Qingchun ZUO Xiaoling TIAN Yunxia WANG Li(Department of Radiology, The First Hospital of Shijiazhuang City, Shifiazhuang 050011, Chyina)

机构地区：[1]石家庄市第一医院放射科,河北省石家庄市050011 [2]河北医科大学第二医院放射科,河北省石家庄市050000

出　　处：《实用医学杂志》2017年第4期576-579,共4页The Journal of Practical Medicine

基　　金：河北省医学科学研究重点课题(编号:20160804)

摘　　要：目的:探讨肺腺癌纯磨玻璃密度结节(pure ground-glass opacity,p GGO)内部CT影像学特征。方法:回顾性分析156个手术病理证实的p GGO结节内部CT影像特点。所有p GGO结节中浸润前病变58个(包括不典型腺瘤样增生及原位腺癌)、微浸润腺癌32个和浸润性腺癌66个。p GGO结节内部CT影像特征包括病变密度均匀/不均匀、空泡征、空气支气管征及病变内走行血管异常改变(血管扩张、扭曲、僵直)。结果:p GGO结节中密度不均、病变内血管异常改变在3种不同病理分型中差异有统计学意义(χ2=7.452,P=0.024;(χ2=22.615,P<0.001),随着结节浸润程度的增加,病变密度不均及其内血管异常改变的发生率随之增加;空气支气管征的发生率亦随病变浸润程度的加深而增高,但其仅对于浸润前病变与浸润性病变(包括微浸润腺癌和浸润性腺癌)的鉴别诊断有价值(χ~2=4.868,P=0.027)。结论:p GGO结节内部密度不均、血管异常改变对肺腺癌不同病理类型的鉴别具有一定的价值。Objective To discuss the pathological classification and lesion＇s inner imaging features of lung adenocarcinoma presented as pure ground-glass opacity. Methods CT imaging features of 156 pGGO lesions which confirmed by surgery and pathology were analyzed in retrospectively. There were 58 lesions of pre-invasive （ including atypical adenomatous hyperplasia and adenocarcinoma in situ ） , 32 lesions of minimally invasive adenocarcinoma and 66 lesions of invasive adenocarcinoma. CT features were analyzed including lesion density, vacuole sign, air bronchogram and abnormal vascular changes （vascular dilatation, distortion or rigid）. Results There were statistical difference in lesions density and abnormal vascular changes in 3 different pathological types （ P 〈 0.05）, with increase of lesions invasive, the incidence of uneven density and abnormal vascular changes increase, its mean the more invasive of the lesion, the lesion tent to be more uneven and higher incidence of the dilation, twist or rigid of the vascular happened ; while the incidence of the air bronchogram will be higher when the lesions invasive degree increased, but there was statistical difference only between the pre-invasive and invasive groups （including minimally invasive adenocarcinoma and invasive adenocarcinoma ） （x^2 = 4.868, P = 0.027 ）. Conclusions The uneven density and abnormal vascular changes had certain value in differential diagnosis of lung adeno- carcinoma presented as pGGO.

关 键 词：肺肿瘤 腺癌 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]