肺纯磨玻璃结节微浸润腺癌与浸润性腺癌的CT鉴别诊断  

CT Differential Diagnoses of Pulmonary Minimally Invasive Adenocarcinoma and Invasive Adenocarcinoma Presenting as Pure Ground Glass Nodules

作　　者：左玉强[1] 冯平勇[2] 孟庆春[1] 田云霞[1] 左晓玲[1] 乔晓慧[1] 

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

出　　处：《临床放射学杂志》2017年第4期495-498,共4页Journal of Clinical Radiology

基　　金：河北省医学科学研究重点课题(编号:20160804)

摘　　要：目的探讨表现为纯磨玻璃结节(pGGN)的肺微浸润腺癌(MIA)与浸润性腺癌(IAC)的CT鉴别诊断。方法回顾性分析经手术病理证实的表现为pGGN的32例MIA与66例IAC的临床及CT资料,分析病例的年龄、性别及病灶最大径、密度、形态、边缘、内部及邻近结构改变等CT征象,并进行统计学分析。结果 MIA和IAC在年龄、性别方面差异无统计学意义(P值均>0.05);两组CT显示病灶的最大径、密度、形态、瘤-肺界面清晰方面差异无统计学意义(P值均>0.05),分叶征、毛刺征、空气支气管征、pGGN内支气管呈扭曲、扩张样改变及血管集束征两组差异有统计学意义(P值均<0.05)。结论当pGGN病灶伴有分叶征、毛刺征、空气支气管征、pGGN内支气管呈扭曲、扩张样改变及血管集束征时,其为IAC的可能性更大。Objective Discuss the CT imaging features of minimally invasive adenocarcinoma（MIA） and invasive ade- nocarcinoma（IAC） of the lung presenting as pure ground glass nodules, and explore their differential diagnoses on CT images. Methods A retrospective analysis of clinical data and CT images of 32 cases of MIA and 66 cases of IAC confirmed by puncture or surgical pathology was made. The patient＇s age ,sex and lesion＇s size, density, shape, margin, changes in the internal and adjacent structure） were statistically analyzed. Results There were no statistically significant differences in the age and sex between the two groups （ P all 〉 0.05 ）. CT imaging showed there were no significant differences in tumor size, density, shape and tumor-lung interface between the two groups（ P all 〉 0.05 ）. However, these images indicated that there were significant differences in lobulation, spiculation, air bronchaograrns ,the bronchial distortion and extension in the pGGN and vascular convergence signs （P all 〈 0.05） , which were frequently observed in the IAC group. Conclusion When pGGN lesions had lobulation, spiculation, air bronchaogram , bronchial distortion and extension in the pGGN and vascular convergence signs, they were more likely to be diagnosed as IAC.

关 键 词：磨玻璃结节 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]