HRCT扫描对纯磨玻璃结节侵袭性的预测价值研究  

Study on Predictive Value of HRCT Scan on Invasiveness of Pure Ground-Glass Nodules

作　　者：张晶晶 张强 董旭鹏 ZHANG Jing-jing;ZHANG Qiang;DONG Xu-peng(Imaging Center,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei Province,China;Department of Oncology,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei Province,China)

机构地区：[1]秦皇岛市第一医院影像中心,河北秦皇岛066000 [2]秦皇岛市第一医院肿瘤科,河北秦皇岛066000

出　　处：《中国CT和MRI杂志》2022年第11期67-69,共3页Chinese Journal of CT and MRI

基　　金：秦皇岛市科学技术研究与发展计划项目(201902A110)。

摘　　要：目的研究高分辨率CT(HRCT)对肺部纯磨玻璃结节侵袭性的预测价值。方法选取2019年3月至2020年5月我院收治确诊CT影像学报告显示为肺部纯磨玻璃结节患者100例,共109个结节,分为浸润组(包括MIA及IAC,n=44)及未浸润组(包括炎症、AAH、AIS,n=65),分析各组结节HRCT征象,评估各CT参数诊断纯磨玻璃结节侵袭性的价值。结果浸润组结节直径为(9.23±2.16)mm,平均CT值为(-527.69±56.16)HU高于非浸润组结节直径为(7.41±1.81)mm,平均CT值为(-613.54±62.38)HU(P﹤0.05);浸润组分叶征检出率为54.55%,高于非浸润组的23.08%(P﹤0.05);两组最大CT值、最小CT值、CT差值比较差异均具有统计学意义(P﹤0.05);多因素分析结果显示平均CT值、平均直径是影响纯磨玻璃结节浸润程度的相关影响因素(P﹤0.05);受试者工作特征曲线(ROC)显示平均直径临界值为7.920 mm时鉴别结节是否呈现浸润性有较高的效能,AUC为0.846,敏感度为88.9%,特异性为73.0%。平均CT值临界值为-560.43 HU,AUC为0.808,敏感度为77.8%,特异性为75.0%。结论HRCT结节平均直径、平均CT值对HRCT检查报告显示为纯磨玻璃结节的患者是否出现浸润性病变具有较好的鉴别意义,有助于指导临床治疗方式的选择。Objective To study the predictive value of high-resolution CT(HRCT)on the invasiveness of pure ground-glass nodules in the lung.Methods 100 patients with pure ground-glass nodules in the lungs shown by confirmed CT imaging reports in the hospital were selected between March 2019 and May 2020,109 nodules in total.The nodules were divided into infiltration group(including MIA and IAC,n=44)and non-infiltration group(including inflammation,AAH and AIS,n=65).The HRCT signs were analyzed in each group of nodules,and the value of each CT parameter in diagnosing the invasiveness of pure ground-glass nodules was evaluated.Results The diameter of nodules and average CT value were(9.23±2.16)mm and(-527.69±56.16)HU in infiltration group.Which were higher than(7.41±1.81)mm and(-613.54±62.38)HU in non-infiltration group(P﹤0.05).The incidence rate of lobular sign with 54.55%in infiltration group was higher than 23.08%in non-infiltration group(P﹤0.05).The differences in terms of maximum CT value,minimum CT value and CT difference were statistically significant between the two groups(P﹤0.05).Multivariate analysis results showed that the average CT value and average diameter were related influencing factors affecting the infiltration degree of pure ground-glass nodules(P﹤0.05).Receiver operating characteristic(ROC)curve results displayed that when the critical value of average diameter was 7.920 mm,there was a higher efficiency in identifying whether nodules were infiltrating,and the AUC,sensitivity and specificity were 0.846,88.9%and 73.0%.The cut-off value,AUC,sensitivity and specificity of average CT value were-560.43 HU,0.808,77.8%and 75.0%.Conclusion The average diameter and average CT value of HRCT nodules have good distinguishing significance for the presence or absence of infiltrating lesions in patients whose HRCT examination report shows pure ground-glass nodules,and can help guide the choice of clinical treatment.

关 键 词：高分辨率CT 纯磨玻璃结节 预测 价值 

分 类 号：R445.3[医药卫生—影像医学与核医学]