HRCT对肺原位腺癌、微浸润腺癌鉴别诊断价值研究  

Differential Diagnosis Value of HRCT for Adenocarcinoma in Situ and Minimally Invasive Adenocarcinoma

作　　者：张榆铃 陈余思[1] 白碧慧 苏晓勇[1] ZHANG Yu-ling;CHEN Yu-si;bAI bi-hui;SU Xiao-yong(Department of Respiratory and Critical Medicine,Panzhihua Hospital of Integrated traditional Chinese and Western Medicine,Panzhihua 617000,Sichuan Province,China)

机构地区：[1]攀枝花市中西医结合医院呼吸与危重症医学科,四川攀枝花617000

出　　处：《中国CT和MRI杂志》2022年第6期59-61,共3页Chinese Journal of CT and MRI

基　　金：四川省科技厅资助项目(2016JY0108)。

摘　　要：目的分析高分辨率CT(HRCT)对肺原位腺癌(AIS)、微浸润腺癌(MIA)的鉴别诊断价值。方法分析2017年12月至2019年12月我院收治86例肺腺癌患者临床病理及影像学资料,分析HRCT中肺腺癌的影像学特征,并比较不同类型肺癌相关特征差异。结果在HRCT的影像特征中,AIS和MIA在肺动脉异常、“空泡”征及多发病灶比较上无差异(P>0.05);但圆形/椭圆形病灶更多见于AIS,分叶型病灶更多见于MIA,MIA中“毛刺”佂较多,混合磨玻璃结节存在更多,病灶及实性成分直径更长,肺静脉异常、空气支气管佂及胸膜“凹陷”佂发生率均更高(P<0.05);AIS与MIA在纯磨玻璃结节和混合磨玻璃结节的磨玻璃结节密度区的CT值比较无差异(P>0.05),但实性结节密度区AISCT值显著低于MIA(P<0.05)。结论HRCT检查可明确显示肺腺癌的病灶情况,而AIS和MIA在HRCT中的影像学特征存在一定的差异,故该检查对鉴别AIS和MIA具有一定的诊断价值,可为后续临床治疗提供更好的指导依据。Objective To analyze the differential diagnosis value of high-resolution CT(HRCT)for adenocarcinoma in situ(ATS)and minimally invasive adenocarcinoma(MIA).Methods The clinical and pathological and imaging data of 86 patients with lung adenocarcinoma admitted in our hospital from December 2017 to December 2019 were analyzed,the imaging characteristics of lung adenocarcinoma in HRCT were analyzed,and the differences in related characteristics of different types of lung cancer were compared.Results In the HRCT imaging features,there were no differences in abnormalities of pulmonary artery,vacuole signs,and multiple lesions between AIS and MIA(P>0.05).However,round/oval lesions were more common in AIS,and lobular lesions were more common in MIA.There were more burrs in MIA,more mixed ground glass nodules.The lesions and solid components were longer in diameter,the incidence of abnormalities of pulmonary vein,air bronchus and pleural depression were higher(P<0.05).There was no difference in CT value of the ground glass nodule density area of pure ground glass nodule and mixed ground glass nodule between AIS and MIA(P>0.05),but the AISCT value of solid nodule density area was significantly lower than that of MIA(P<0.05).Conclusion The HRCT test can clearly show the lesions of lung adenocarcinoma,but the imaging characteristics of AIS and MIA in HRCT are different.Therefore,this test has some diagnostic value in distinguishing AIS from MIA,and can provide better guidance for subsequent clinical treatment.

关 键 词：高分辨率CT 肺原位腺癌 微浸润腺癌 图像表现 鉴别诊断 

分 类 号：R563[医药卫生—呼吸系统] R445.3[医药卫生—内科学]