均具有毛刺的周围型肺癌与炎性结节的CT表现对比研究  

Comparison of CT findings of peripheral lung cancer with spiculations and inflammatory nodules with spiculations

作　　者：郭月飞[1] 段亚妮 董云旭[1] 朱雁秋 陈秀珍[1] 覃杰[1] GUO Yuefei;DUAN Ya′ni;DONG Yunxu;ZHU Yanqiu;CHEN Xiuzhen;QIN Jie(Department of Radiology,the Third Affiliated Hospital,Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院放射科,广东广州510630

出　　处：《中国医学物理学杂志》2018年第11期1276-1280,共5页Chinese Journal of Medical Physics

基　　金：国家自然科学青年科学基金(81101096);广东省医学科研基金(B2011102);广东省科技计划项目(2015A020212017);广东省自然科学基金(2016A030313323;2017A030313841)

摘　　要：目的:对比分析均具有毛刺的周围型肺癌及炎性结节的CT表现特点。方法:收集73例直径≤3 cm具有毛刺并经病理学诊断的肺孤立性结节,分为肺癌组42例,炎性结节组31例。对比分析两组结节的大小、密度、强化程度、是否分叶、是否有空洞以及结节的毛刺长短、粗细、数量和分布。结果:具有毛刺的肺癌[(1.93±0.65)cm]大于具有毛刺的炎性结节[(1.46±0.56)cm],差异有统计学意义(t=3.24, P<0.05)。相对于具有毛刺的炎性结节,分叶多见于具有毛刺的肺癌(25.81%vs 50.00%)(χ~2=4.36, P<0.05),而空洞在两者的出现率(9.68%vs 14.29%)差异无统计学意义(χ~2=0.35, P>0.05)。肺癌和炎性结节的CT值(44.94±2.88 vs 39.83±3.26, P>0.05)及强化程度(29.07±2.80 vs 27.70±4.46, P>0.05)差异无统计学意义。肺癌毛刺数量[(5.57±3.33)条]多于炎性结节[(3.68±2.40)条],差异有统计学意义(t=2.69, P<0.05)。肺癌和炎性结节的毛刺粗细差异无统计学意义(1.62±0.80 vs 1.54±0.63)(t=0.42, P>0.05)。肺癌毛刺呈周边型分布占28.57%(12/42),胸膜侧分布占54.29%(27/42),肺门侧占7.14%(3/42);炎性结节毛刺呈周边型分布占29.03%(9/31),胸膜侧占58.07%(18/31),肺门侧占12.90%(4/31),肺癌与炎性结节的毛刺分布差异无统计学意义(χ~2=0.73, P>0.05)。结论:结节的大小、分叶及毛刺数量有助于鉴别具有毛刺的周围型肺癌与炎性结节,而毛刺粗细及分布无助于鉴别两者。具有较多毛刺及直径较大的分叶结节提示肺癌的可能性大。Objective To compare the CT images of lung cancer with spiculations and inflammatory nodules with spiculations.Methods A total of 73 cases of pathologically confirmed solitary pulmonary nodules with spiculations and a diameter≤3 cm were selected,including 42 cases of lung cancer and 31 of inflammatory nodules.The CT features of all these cases,including the size,density,enhancement,lobulation,cavity of nodules,and the lengths,diameters,number and distribution of spiculations,were compared between lung cancer and inflammatory nodules.Results Lung cancer with spiculations were significantly larger than the inflammatory nodules with spiculations,with statistical differences[(1.93±0.65)cm vs(1.46±0.56)cm,t=3.24,P<0.05].Lobulation was more common in lung cancer group than in inflammatory nodules group(50.00%vs 25.81%,χ^2=4.36,P<0.05),while the incidence of cavity was similar in inflammatory nodules group and in lung cancer group(9.68%vs 14.29%,χ^2=0.35,P>0.05).No statistical differences were found in CT density and enhancement between lung cancer group and inflammatory nodules group(44.94±2.88 vs 39.83±3.26,P>0.05;29.07±2.80 vs 27.70±4.46,P>0.05).The number of spiculations in lung cancer was more than that in inflammatory nodules,with statistical significance(5.57±3.33 vs 3.68±2.40,t=2.69,P<0.05),but the diameter of spiculations in lung cancer was close to that in inflammatory nodules(1.62±0.80 vs 1.54±0.63,t=0.42,P>0.05).The spiculations of lung cancer were distributed mainly in periphery in 28.57%(12/42)patients,pleura in 54.29%(27/42)patients and hilum of the lung in 7.14%(3/42)patients,and the spiculations of inflammatory nodules were distributed mainly in periphery in 29.03%(9/31)patients,pleura in 58.07%(18/31)patients and hilum of the lung in 12.90%(4/31)patients.There was no statistical differences in the spiculation distribution between lung cancer group and inflammatory nodules group(χ^2=0.73,P>0.05).Conclusion The size,lobulation of nodules and number of spiculations are helpful in distinguis

关 键 词：肺癌 肺炎性结节 毛刺 X线计算机体层摄影术 

分 类 号：R445.3[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]