计算机辅助诊断定量测量在鉴别纯磨玻璃结节早期肺腺癌中的应用价值  

The value of differential diagnosis using computer-aided diagnosis quantitative evaluation in early lung adenocarcinoma with pure ground glass nodules

作　　者：冯会[1] 时高峰[1] 杜煜[1] 王丽佳[1] 范雪丽 徐同欣 FENG Hui;SHI Gaofeng;DU Yu;WANG Lijia;FAN Xueli;XU Tongxin(CT/MR Room,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院CT/MR科,河北石家庄050011

出　　处：《实用放射学杂志》2021年第2期216-219,共4页Journal of Practical Radiology

摘　　要：目的应用计算机辅助诊断(CAD)定量评估表现为纯磨玻璃结节(pGGN)的早期肺腺癌,区分浸润性腺癌(IA)和浸润前/微浸润病灶。方法将121例薄层CT表现为pGGN的早期肺腺癌患者纳入研究,利用CAD软件测量获得最大径、垂直径、平均CT值、体积值,同时计算平均直径和质量,并记录有无毛刺、分叶、空泡和胸膜牵扯征象。结果IA的最大径、平均直径、平均CT值、体积和质量均高于浸润前/微浸润病灶,2组间差异有统计学意义(P<0.05),受试者工作特征(ROC)曲线显示质量和体积的诊断效能较高,曲线下面积(AUC)分别为0.865和0.802,观察者间和观察者内一致性较好。形态学方面,胸膜牵扯征在2组间差异有统计学意义(P<0.05)。结论利用CAD可以定量评估pGGN中的内部特征,特别是体积和质量有助于区分浸润性病变和浸润前/微浸润病变。Ohjective To evaluate early lung adenocarcinoma presenting as pure ground glass nodule(pGGN)and to make a distinction between invasive adenocarcinoma(IA)and pre-invasive/micro invasive lesions using computer aided diagnosis(CAD)quantitative evaluation.Methods A total of 121 patients with early lung adenocarcinoma presenting as pGGN in thin-slice CT were enrolled in this study.CAD software was used to measure the maximum diameter。vertical diameter。average CT value and volume of lesions.Moreover。the.average diameter and mass were calculated,and the signs of burr,lobular。bubble lucency and pleural involvement were reorded.Results The maximum diameter。vertical diameter,average CT value,volume and mass of IA were all higher than those of the pre invasive/micro invasive lesions.The difference between the two groups was statistically significant(P<0.05).The receiver operating characteristic(ROC)curve showed that the diagnostic eficiency of mass and volume was excellent。with area under the curve(AUC)of 0.865 and 0.802。respectively.The intraobserver and interobserver agreerment was desirable.With respeet to morphology。the difference of pleural involvement was statistically significant between the two groups(P<0.05).Conclusion CAD can be used to quantitatively evaluate the internal features of pGGN,especially volume and mass to help distinguish between invasive and pre invasive/micro invasive lesions.

关 键 词：肺腺癌 磨玻璃结节 计算机辅助诊断 定量测量 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]