HRCT征象评估纯磨玻璃结节浸润性:肺结节圆度优于长-短径比值和分叶深度  

Application value of pulmonary nodule roundness on HRCT in predicting invasiveness of pure ground glass nodules and its correlation with long-short diameter ratio and depth of lobulation

作　　者：巴文娟 许迪 尹柯 沈晶[1] 汤敏 刘金沙 谢梅 伍建林[1] BA Wen-juan;XU Di;YIN Ke(Department of Radiology,the Affiliated Zhongshan Hospital of Dalian University,Liaoning 116001,China)

机构地区：[1]大连大学附属中山医院放射科,辽宁116001

出　　处：《放射学实践》2020年第12期1542-1546,共5页Radiologic Practice

基　　金：大连市科技局科技计划项目及大连市领军人才科技项目(2015E12SF120)。

摘　　要：目的:探讨HRCT上肺结节圆度在预测纯磨玻璃结节(pGGN)浸润性中的应用价值及其与肺结节长-短径比值和分叶深度的相关性。方法:回顾性分析经病理证实的111例共计116个pGGNs的HRCT表现。将所有病灶分为浸润前病变组(n=63)和浸润性病变组(n=53),前者包括非典型腺瘤样增生(AAH)和原位腺癌(AIS),后者包括微浸润性腺癌(MIA)和浸润性腺癌(IA)。使用Photoshop CS6软件测量pGGN的圆度,比较两组间圆度值的差异,利用ROC曲线评估圆度、长-短径比和分叶深度在鉴别2组病变中的最佳截断值和诊断效能,并分析3个指标间的相关性。结果:浸润前病变组和浸润性病变组pGGN的圆度值分别为79.9%±4.2%和68.5%±7.7%,两组间差异有统计学意义(P<0.05)。ROC曲线分析显示pGGN的圆度值、长-短径比和分叶深度的截断值分别为73.4%、1.204和0.081,AUC分别为0.902、0.635和0.753。圆度值与长-短径比值、分叶深度均呈负相关(r=-0.498,P<0.01;r=-0.672,P<0.01)。结论:相对于长-短径比和分叶深度,圆度对pGGN浸润性的预测具有更高的准确性。Objective:The purpose of this study was to explore the value of pulmonary nodule roundness on high resolution CT(HRCT)in predicting the invasiveness of pure ground glass nodules(pGGN)and its correlation with the long-short diameter ratio and the depth of lobulation of pulmonary nodule.Methods:A total of 116 pGGN lesions proven pathologically were divided randomly into pre-invasive group(n=63)and invasive group(n=53).The former included atypical adenomatous hyperplasia(AAH)and adenocarcinoma in situ(AIS),the latter included minimally invasive adenocarcinoma(MIA)and invasive adenocarcinoma(IA).Photoshop CS6 software was used to measure pulmonary nodule roundness,and the difference of the roundness between the two groups were analyzed statistically.ROC curve was used to identify the best cut-off values and diagnostic efficacy for prediction of the invasiveness of pGGN,and the correlation of roundness,long-short diameter ratio and depth of lobulation of pulmonary nodule was evaluated.Results:The roundness value of pGGNs was 79.9%±4.2%in the pre-invasive group and 68.5%±7.7%in the invasive group(P<0.05).The best cut-off values of the pulmonary nodule roundness,long-short diameter ratio and lobulation depth were 73.4%,1.204 and 0.081,respectively;and the corresponding AUCs were 0.902,0.635 and 0.753,respectively.Inverse correlation was observed between the long-short diameter ratio,depth of lobulation with pulmonary nodule roundness(r=-0.498,P<0.01;r=-0.672,P<0.01).Conclusion:Compared with long-short diameter ratio and depth of lobulation,the roundness of pulmonary nodule has higher accuracy in predicting infiltration of pGGN.

关 键 词：纯磨玻璃结节 肺腺癌 浸润性 高分辨力CT 肺结节圆度 

分 类 号：R814.42[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]