CT定量分析预测肺部肿瘤性磨玻璃结节病理侵袭性的价值  

Quantitative CT analysis of pulmonary ground-glass nodule predicts histological invasiveness

作　　者：代平 何其舟 王思凯 刘姝兰 宋杨 王洪飞 DAI Ping;HE Qi-zhou;WANG Si-kai(The Traditional Chinese Affiliated hospital of Southwest medical university,Luzhou 646000,China)

机构地区：[1]西南医科大学附属中医医院放射科,泸州646000 [2]西南医科大学附属中医医院病理科,泸州646000

出　　处：《放射学实践》2019年第10期1108-1112,共5页Radiologic Practice

摘　　要：目的:探讨CT定量分析预测肺部肿瘤性磨玻璃结节病理侵袭性的价值。方法:回顾性分析97例经临床证实的肺部磨玻璃结节,依据病理类型分为3组,分别为浸润前病变组(32例)、微浸润腺癌组(29例)与浸润性腺癌组(36例);采用肺结节分析软件进行定量分析,自动计算肺结节的最大横截面长径、面积、体积和密度(最大CT值、最小CT值、平均CT值),分析上述定量指标与3组病理类型间是否有统计学差异,并绘制风险指数的受试者工作曲线(ROC)。结果:最大横截面长径、面积、体积、最小CT值与3组病理类型差异无统计学意义(P>0.05);平均CT值、最大CT值与3组病理类型差异有统计学差异(P<0.05);3组病理类型的最大CT值分别为(142.19±133.12)、(180.72±90.51)和(260.17±134.62)HU;3组病理类型的平均CT值分别为-642.50(-693.50,-593.50)、-530.00(-567.00,-519.50)、-324.50(-393.75,-190.25);平均CT值鉴别浸润前与浸润性病变组(微浸润+浸润性)的最佳临界值为-557HU,诊断浸润性病变的敏感度、特异度分别为86.2%、93.7%;平均CT值鉴别微浸润与浸润性腺癌组的最佳临界值为-484HU,诊断浸润性腺癌的敏感度、特异度分别为94.4%、96.6%。结论:定量分析指标中的平均CT值和最大CT值对磨玻璃结节的病理侵袭性有预测作用。Objective: To investigate the value of CT quantitative analysis in predicting the pathological invasiveness of ground glass nodules (GGNs). Methods: We retrospectively evaluated 97 pulmonary GGNs,and pathologically classified them as pre-invasive lesions (32 cases),minimally invasive adenocarcinoma (29 cases) and invasive pulmonary adenocarcinoma (36 cases);The maximum cross-sectional length,area,volume and density (maximum CT value,minimum CT value,mean CT value) of lung nodules of the three groups were compared.and Receiver operating characteristic (ROC) curve was used for analyzing the risk index. Results: There was no significant difference in the maximum cross-sectional length,area,volume and minimum CT value between the three groups ( P >0.05).There was significant difference in maximum CT value and mean CT value among the three groups ( P < 0.05).The maximum CT values of the three groups were (142.19±133.12)HU,(180.72± 90.51)HU and (260.17±134.62)HU respectively;the mean CT values of the three groups were -642.50 (-693.50,-593.50),-530.00(-567.00,-519.50)and -324.50(-393.75,-190.25) respectively;The cut off value of mean CT value to differentiate pre-invasive and invasive lesions (minimally invasive+invasive) was -557HU,the sensitivity and specificity of the diagnosis of invasive lesions were 86.2% and 93.7% respectively.The cut off value of mean CT value to differentiate minimally invasive and invasive lesions was -484HU,the sensitivity and specificity of the diagnosis of invasive lesions were 94.4% and 96.6% respectively. Conclusion: The mean CT value and the maximum CT value can predict the pathological invasiveness of ground glass nodules.

关 键 词：肺肿瘤 体层摄影术 X线计算机 定量评价 病理学 

分 类 号：R734.2[医药卫生—肿瘤] R814.4[医药卫生—临床医学]