MSCT多平面重建技术用于磨玻璃结节样肺腺癌的鉴别诊断价值研究  

Value of MSCT Multiplanar Reconstruction in the Differential Diagnosis of Ground Glass Nodular Lung Adenocarcinoma

作　　者：龚海鹏 司海峰[1] 邢金丽[1] 丁勇生[1] GONG Hai-peng;SI Hai-feng;XING Jin-li;DING Yong-sheng(Department of Radiology,Nantong Cancer Hospital/Affiliated Cancer Hospital of Nantong University,Nantong 226001,Jiangsu Province,China)

机构地区：[1]南通市肿瘤医院/南通大学附属肿瘤医院影像科,江苏南通226001

出　　处：《中国CT和MRI杂志》2023年第2期52-54,共3页Chinese Journal of CT and MRI

基　　金：2021年度南通市卫生健康委员会面上B项目(MB2021037)。

摘　　要：目的 通过将多层螺旋CT(MSCT)多平面重建技术应用于磨玻璃结节(GGN)样肺腺癌的临床诊断,探讨MSCT对其鉴别诊断的价值。方法 回顾性收集2019年5月~2022年4月至我院就诊的150例GGN样肺腺癌患者(共150个结节)的临床资料,根据手术后病理结果,将其分为浸润前病变组(86例)和浸润性病变组(64例)。对所有入组患者MSCT图像进行分析,比较两组患者MSCT征象;以手术后病理组织学检查结果为基准,分析MSCT对p GGN样肺腺癌的诊断效能及对病理分型诊断准确率。结果 浸润前病变组与浸润性病变组患者在病灶大小、边缘情况、血管“集束”征、胸膜“凹陷”征方面存在显著性差异(P<0.05),其中浸润性病变边缘多见“分叶”征或“毛刺”征,形态以类圆形为主。MSCT诊断p GGN样浸润性病变的敏感度为92.19%,特异度为93.02%,准确性92.67%。MSCT对不典型腺瘤样增生(AAH)、原位腺癌(AIS)、微浸润性腺癌(MIA)、浸润性腺癌(IAC)诊断准确率分别是100%、100%、94.44%、89.29%,与病理学检查结果相比,符合率高(P>0.05)。结论 MSCT多平面重建技术对于GGN样肺腺癌浸润前病变、浸润性病变的鉴别诊断有较高价值,且有助于进行不同病理亚型诊断。Objective To investigate the value of multi-slice spiral CT(MSCT) multiplanar reconstruction in the differential diagnosis of ground-glass nodular(GGN) lung adenocarcinoma. Methods The clinical data of 150 patients with GGN lung adenocarcinoma(150 nodules in total) who were treated in the hospital from May 2019 to April 2022 were retrospectively collected. According to postoperative pathological results,the patients were divided into pre-invasive lesion group(86 cases) and invasive lesion group(64 cases). MSCT images of all patients were analyzed,and MSCT signs were compared between the two groups. The postoperative pathological results were taken as the standard to analyze the diagnostic performance of MSCT for pGGN lung adenocarcinoma,and accuracy rate of classifications.Results There were significant differences in the size of lesion,edge,vessel convergence sign,and pleural indentation between the two groups(P<0.05). Invasive lesions mainly showed lobulation sign or spicule sign on the edge,and most were quasi-circular. The sensitivity,specificity and accuracy of MSCT in the diagnosis of pGGN invasive lesions were 92.19%,93.02% and 92.67%,respectively. The diagnostic accuracy rates for atypical adenomatous hyperplasia(AAH),adenocarcinoma in situ(AIS),minimally invasive adenocarcinoma(MIA) and invasive adenocarcinoma(IAC) were 100%,100%,94.44% and 89.29%,respectively. Compared with pathological results,the coincidence rate was high(P>0.05).Conclusion MSCT multiplanar reconstruction is helpful for differential diagnosis of pre-invasive lesions and invasive lesions in GGN lung adenocarcinoma,and is conducive to pathological classification.

关 键 词：MSCT 多平面重建技术 磨玻璃结节样 肺腺癌 鉴别诊断 

分 类 号：R322.35[医药卫生—人体解剖和组织胚胎学]