CT阈值分割法在肺内亚实性结节病理学分类和浸润等级判定中的应用  

Application of CT Threshold Segmentation Method in the Pathological Classification and Infiltration Grade Judgment of Ground Glass Nodules and Partial Solid Nodules in the Lung

作　　者：黄伟康 吴水天 陈洁文 霍杰坤 文戈 HUANG Wei-kang;WU Shui-tian;CHEN Jie-wen;HUO Jie-kun;WEN Ge(Zengcheng Branch Of Nanfang Hospital,Southern Medical University,Guangzhou Guangdong 511340)

机构地区：[1]南方医院增城分院广州市增城区中心医院,广东广州511340

出　　处：《深圳中西医结合杂志》2021年第5期92-95,F0003,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：广东省医学科学技术研究基金项目资助课题(C2019077)。

摘　　要：目的:探讨CT阈值分割法在肺内磨玻璃结节和部分实性结节病理学分类和浸润等级判定中的应用价值。方法:选取2019年1月至2020年11月南方医院增城分院计算机断层扫描(CT)影像科检查出的90例肺内亚实性结节(SSN)患者,根据病理检查结果分为低浸润组50例和高浸润组40例,比较两组患者的CT扫描定量参数及其在浸润等级中的独立预测因素,进而分析CT阈值分割法对SSN患者病理浸润等级判断的临床价值。结果:不同CT阈值下,阈值为–250 HU时,亚实性结节类型诊断效能最高。高浸润组肺窗实性一维长径(1D–SCLW)、肺窗实性二维长径(2D–SCLW)、纵膈窗实性一维长径(1D–SCMW)、纵膈窗实性二维长径(2D–SCMW)、安全阈值(SCT)等CT扫描定量参数均显著高于低浸润组,差异均具有统计学意义(P<0.001)。对CT定量参数进行多因素回归分析发现,SCT是亚实性肺结节病理浸润的独立预测因素〔OR=1.164,95 % CI(1.137,1.192)〕。结论:CT阈值分割法可准确判断SSN类型,并进行定量体积分析,SCT是病理浸润等级的独立预测因素,且SCT越大,肺结节浸润程度越高。Objective To explore the application value of CT threshold segmentation in the pathological classification and infiltration grade determination of ground glass nodules and some solid nodules in the lung.Methods Select 90 patients with subsolid nodules in the lung detected by the CT imaging department of Zengcheng branch of Nanfang hospital from January 2019 to November 2020,and divide them into low-invasive group with 50 cases and high-invasive group with 40 cases according to the pathological examination results,and compare the two groups The quantitative parameters of CT scans and their independent predictors in the level of invasion were analyzed,and the clinical value of CT threshold segmentation in judging the level of pathological invasion in patients with subsolid nodules in the lung was analyzed.Results Under different CT thresholds,when the threshold is-250 HU,the diagnostic efficiency of subsolid nodules is the highest.The quantitative parameters of CT scan such as 1D-SCLW,2D-SCLW,1D-SCMW,2D-SCMW,SCT in the high-invasive group were significantly higher than those in the low-invasive group (P ﹤ 0.001).Multivariate regression analysis of CT quantitative parameters found that SCT was an independent predictor of pathological infiltration of subsolid pulmonary nodules[OR=1.164,95% CI (1.137,1.192)].Conclusion The CT threshold segmentation method can accurately determine the type of subsolid pulmonary nodules,and perform quantitative volume analysis to determine that subsolid volume is an independent predictor of pathological infiltration grade,and the larger the subsolid volume,the higher the degree of lung nodule infiltration It has high clinical application value for pathological judgment and prognostic evaluation of subsolid nodules.

关 键 词：肺内亚实性结节 腺癌 肺内磨玻璃结节 肺内部分实性结节 计算机断层扫描阈值分割法 

分 类 号：R734.2[医药卫生—肿瘤] R445[医药卫生—临床医学]