肺磨玻璃结节的胸部CT影像特征及其对结节良恶性的诊断价值  

Chest CT features of pulmonary ground-glass nodules and their diagnostic value for benign and malignant nodules

作　　者：陈师 胡剑鹏[1] 徐伟[1] 张骥[1] 吴吉明[1] CHEN Shi;HU Jianpeng;XU Wei;ZHANG Ji;WU Jiming(Department of Cardiothoracic Surgery,the First People's Hospital of Changde City in Hu′nan Province,Changde 415000,China)

机构地区：[1]湖南省常德市第一人民医院心胸外科,湖南常德415000

出　　处：《中国现代医生》2021年第33期134-137,共4页China Modern Doctor

基　　金：湖南省科技创新计划项目(2018SK50203);湖南省常德市科学技术局一般项目(2018J020)。

摘　　要：目的探讨肺磨玻璃结节的胸部CT影像特征及其对结节良恶性的诊断价值。方法收集我院2018年5月至2020年5月收治并经手术病例证实的63例肺部孤立磨玻璃结节样肺腺癌患者的CT图像,由2名从事胸部影像诊断10年以上医生通过评估病变部位、形态、大小、边缘、边界、内部结构、与邻近结构的关进行回顾性分析。结果63例患者中右肺36例,左肺27例,病灶呈不规则形12例,圆形、类圆形51例。结节最大径0.71~2.83 cm,平均1.79 cm。瘤-肺界面清晰43例,不清晰20例。毛刺征45例,18例表面光滑;深分叶8例,浅分叶42例,13例边缘规则。细支气管充气征15例,“空泡征”33例,见斑点状密度减低影23例,纯磨玻璃结节23例,混合磨玻璃结节40例。胸膜及叶间胸膜凹陷28例,血管集束征19例,5例血管绕行,血管穿行病灶18例,8例未见确切支气管影,支气管扭曲、走行僵硬43例,支气管连续性中断12例。结论综合分析磨玻璃结节的部位、大小、形态、边缘、边界、内部结构、与邻近结构的关系等CT征象,对磨玻璃结节样病变性质的早期判断,尽早给予医学干预。Objective To investigate the chest CT features of pulmonary ground-glass nodules and their diagnostic value for benign and malignant nodules.Methods The CT images of 63 patients with solitary ground-glass nodule-like lung adenocarcinoma admitted to our hospital and confirmed by surgical cases from May 2018 to May 2020 were collected.Two doctors who have been engaged in chest imaging diagnosis for more than ten years conducted a retrospective analysis by evaluating the lesion location,shape,size,edge,boundary,internal structure,and relationship with neighboring structures.Results Among the 63 patients with lesions,36 were in the right lung,and 27 were in the left lung.The lesions were irregular in 12 cases and round and round-like in 51 cases.The maximum diameter of the nodules ranged from 0.71 to 2.83 cm,with an average of 1.79 cm.The tumor-lung interface was clear in 43 cases and unclear in 20 cases.There were 45 cases of burr sign,18 cases of smooth surface,8 cases of deep lobulation,42 cases of superficial lobulation,and 13 cases of regular margin.There were 15 cases of bronchiolar inflation sign,33 cases of"vacuole sign,"23 cases of spotty density reduction,23 cases of pure ground-glass nodules,and 40 cases of mixed ground-glass nodules.There were 28 cases of pleural and interlobar pleural indentation,19 cases of vascular convergence sign,5 cases of vascular bypass,18 cases of vascular puncture lesions,8 cases of no exact bronchial shadow,43 cases of bronchial distortion and stiffness,and 12 cases of bronchial continuity interruption.Conclusion The CT signs of ground-glass nodules,including the location,size,shape,margin,boundary,internal structure,relationship with adjacent structures,are comprehensively analyzed.The nature of ground-glass nodules is early judged,and medical intervention should be given as soon as possible.

关 键 词：肺磨玻璃结节 胸部CT 良恶性 诊断价值 

分 类 号：R734.2[医药卫生—肿瘤]