CT影像技术在磨玻璃样结节的肺微浸润性腺癌与肺浸润腺癌中的鉴别价值分析  

Analysis of CT differential values of lung MIA and lung IAC of GGNs

作　　者：牛声宝 张宏[1] 李雪松 NIU Sheng-bao;ZHANG Hong;LI Xuesong(Department of Medical Imaging, Nanjing Jiangning Hospital, Nanjing 211100, China;不详)

机构地区：[1]南京市江宁医院医学影像科,江苏南京211100

出　　处：《中国医学装备》2022年第6期59-63,共5页China Medical Equipment

摘　　要：目的:探究电子计算机断层扫描(CT)影像技术在肺浸润性腺癌(IAC)与肺微浸润性腺癌(MIA)的鉴别诊断中的应用及影像学特点。方法:选取在医院胸外科就诊的85例(98个结节)CT表现为磨玻璃样结节(GGNs)患者资料,依据术后病理诊断结果将其分为IAC组(53例,60个结节)和MIA组(32例,38个结节)。对比分析两组GGNs性质(纯磨玻璃、混杂磨玻璃密度结节)、结节直径、平均CT值、形态、边界、有无分叶、毛刺、空泡及胸膜凹陷等影像学特征,并对其相关性进行分析。采用受试者工作特征(ROC)曲线下面积(AUC),评价CT诊断效能。结果:IAC组结节直径、平均CT值均高于MIA组,差异有统计学意义(t=19.148,t=7.566;P<0.05);IAC组结节实性成分大小、比例均高于MIA组,差异有统计学意义(t=16.041,t=33.754;P<0.05)。两组GGNs性质、形态、有无分叶及毛刺比较,差异有统计学意义(t=7.237,t=6.568,t=8.425,t=13.262;P<0.05)。GGNs直径、平均CT值、性质、实性成分大小以及比例是肺腺癌浸润程度的相关影响因素(OR=1.514,OR=2.358,OR=3.916,OR=4.845,OR=1.179;P<0.05)。CT定量参数结节直径、平均CT值、实性成分大小和比例鉴别IAC及MIA的AUC分别为0.861、0.783、0.903和0.849;灵敏度分别为75.0%、86.3%、87.5%和75.0%;特异度分别为84.9%、61.6%、78.9%和77.8%。结论:GGNs患者的CT结节直径、平均CT值、实性成分大小以及实性成分比例对于IAC和MIA的临床鉴别价值较高,CT影像技术有助于明确病情及指导手术治疗方案的选择。Objective: To observe and explore the application and imaging characteristics of computed tomography(CT) imaging technique in the differentiation and diagnosis for lung invasive adenocarcinoma(IAC) and lung minimally invasive adenocarcinoma(MIA). Methods: A total of 85 patients(98 nodules in total) who appeared ground-glass nodules(GGNs) in CT images and admitted to hospital were selected. And they were divided into IAC group(53 cases, 60 nodules) and MIA group(32 cases, 38 nodules) according to the results of pathological diagnosis after surgery. The GGNs properties(pure ground glass opacity nodules, mixed ground glass opacity nodules), nodule diameter, average CT value, morphology, boundary, presence or absence of lobulation, spiculation, vacuole and pleural indentation were compared and analyzed between the two groups, and the correlations of them were also analyzed.The area under curve(AUC) of receiver operating characteristic(ROC) curve was used to evaluate the diagnostic efficiency of CT. Results: The nodule diameter and average CT value in IAC group were significantly higher than those in MIA group(t=19.148, t=7.566, P<0.05), respectively. The size and proportion of solid components of GGNs nodules in IAC group were significantly higher than those in MIA group(t=16.041, t=33.754, P<0.05), respectively.The differences of GGNs properties, morphology, presence or absence of lobulation and spiculation were statistically significant between the two groups(t=7.237, t=6.568, t=8.425, t=13.262, P<0.05). The nodule diameter of GGNs,average CT value, GGNs properties, and size and proportion of solid component were the relative influencing factors of invasive degree of lung adenocarcinoma(OR=1.514, OR=2.358, OR=3.916, OR=4.845, OR=1.179, P<0.05). The AUCs of nodule diameter, average CT value, and size and proportion of solid component of CT quantitative parameters were 0.861, 0.783, 0.903 and 0.849 in discriminating IAC and MIA, respectively, which sensitivities were 75.0%,86.3%, 87.5% and 75.0%, and which specificit

关 键 词：CT影像技术 磨玻璃样结节(GGNS) 肺浸润性腺癌(IAC) 肺微浸润性腺癌(MIA) 影像学特点 

分 类 号：R816.4[医药卫生—放射医学]