胸膜改变对胸膜下孤立性亚实性肺结节CT诊断意义  

VALUE OF PLEURAL CHANGES IN THE DIAGNOSIS OF SUBPLEURAL SOLITARY PULMONARY SUBSOLID NODULES BASED ON COMPUTED TOMOGRAPHY

作　　者：李书强 张传玉[1] LI Shuqiang;ZHANG Chuanyu(Department of Radiology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院放射科,山东青岛266003 [2]青岛市城阳区人民医院影像科

出　　处：《青岛大学学报（医学版）》2023年第1期117-121,共5页Journal of Qingdao University(Medical Sciences)

基　　金：青岛市市南区科技计划项目(2020-2-005-YY)。

摘　　要：目的探讨胸膜改变在胸膜下孤立性亚实性肺结节诊断中的意义。方法回顾性分析青岛大学附属医院和青岛市城阳区人民医院2017年11月—2020年11月收治的192例胸膜下孤立性亚实性肺结节病人的CT影像资料及手术记录。根据肺结节和胸膜的关系将胸膜改变分为4种类型,比较良恶性亚实性肺结节病人胸膜改变的分型情况。结果192例胸膜下孤立性亚实性肺结节中,良性组65例,腺癌组127例(包括浸润前病变21例,微浸润腺癌32例,浸润性腺癌74例)。胸膜改变在良性组和腺癌组间的差异具有统计学意义(χ^(2)=13.935,P=0.003),Ⅰ型和Ⅲ型胸膜改变常见于腺癌,Ⅱ型胸膜改变常见于良性病变,Ⅳ型胸膜改变在良恶性病变中无明显差异。浸润前病变、微浸润腺癌、浸润性腺癌病人间胸膜改变分型差异无统计学意义(χ^(2)=2.721,P=0.843)。结论详细分析胸膜改变分型,对胸膜下孤立性亚实性肺结节定性诊断具有重要意义。Objective To investigate the significance of pleural changes in the diagnosis of subpleural solitary pulmonary subsolid nodules.Methods A retrospective analysis was performed for the computed tomography data and surgical records of 192 patients with subpleural solitary pulmonary subsolid nodules who were admitted to The Affiliated Hospital of Qingdao University and Qingdao Chengyang People’s Hospital from November 2017 to November 2020.Pleural changes were classified into four types according to the association between pulmonary nodules and the pleura,and the classification of pleural changes was compared between the patients with benign pulmonary subsolid nodules and those with malignant pulmonary subsolid nodules.Results Among the 192 cases of subpleural solitary pulmonary subsolid nodules,there were 65 cases of benign nodules and 127 cases of adenocarcinoma(including 21 cases of preinvasive lesions,32 cases of microinvasive adenocarcinoma,and 74 cases of invasive adenocarcinoma).There was a significant difference in pleural changes between the benign group and the adenocarcinoma group(χ^(2)=13.935,P=0.003).TypeⅠandⅢpleural changes were more common in adenocarcinoma,typeⅡpleural changes were more common in benign lesions,and typeⅣpleural changes showed no significant difference between the benign and malignant lesions.There was no significant difference in the classification of pleural changes between preinvasive lesions,microinvasive adenocarcinoma,and invasive adenocarcinoma(χ^(2)=2.721,P=0.843).Conclusion A detailed analysis of the classification of pleural changes is of great significance for the qualitative diagnosis of subpleural solitary pulmonary subsolid nodules.

关 键 词：孤立性肺结节 胸膜 体层摄影术 X线计算机 诊断 

分 类 号：R734.2[医药卫生—肿瘤] R814.4[医药卫生—临床医学]