多层螺旋CT鉴别诊断肺磨玻璃结节中浸润性腺癌与微浸润腺癌的价值  

Value of multi-slice spiral CT in the differential diagnosis of invasive adenocarcinoma and microinvasive adenocarcinoma in pulmonary ground-glass nodules

作　　者：李琴 杨志勇[1] LI Qin;YANG Zhi-yong(Department of Radiology,Rugao People's Hospital,Nantong 226500,China)

机构地区：[1]如皋市人民医院放射科,江苏南通226500

出　　处：《哈尔滨医科大学学报》2024年第6期619-622,638,共5页Journal of Harbin Medical University

基　　金：江苏省基础研究计划(自然科学基金)面上项目(BK20201183)。

摘　　要：目的探究多层螺旋CT(multi-slice spiral CT,MSCT)在鉴别诊断肺磨玻璃结节(ground-glass nodules,GGN)中的浸润性腺癌(invasive adenocarcinoma,IAC)与微浸润腺癌(microinvasive adenocarcinoma,MIA)的应用价值。方法收集2018年6月~2023年11月我院影像科诊断为GGN并接受手术治疗的80例患者临床资料进行回顾性分析。患者术前进行MSCT扫描,图像经由具有3年及以上工作经验的两位CT诊断医师进行分析,将分析结果与病理结果对比分析。结果病理结果显示,其中37枚病灶为IAC,43枚病灶为MIA。两组间的性别、有无吸烟史、病灶位置、病灶形状、有无空泡征、有无空气支气管征比较无显著差异(P>0.05);两组患者病灶的平均直径、平均CT值、边缘情况、血管集束征情况、血管穿行征情况、胸膜凹陷征情况、以及结节类型的比较均差异显著(P<0.05)。Logiscit回归分析结果显示,GGN的独立危险因素包括病灶平均直径和平均CT值(P<0.05)。受试者工作特征(receiver operating characteristic,ROC)曲线分析显示,以病灶平均直径≥1.50 cm和平均CT值≥-491.00 Hu作为鉴别IAC和MIA的分界点具有较高的灵敏度和特异度。结论GGN的病理分级与其MSCT征象具有相关性,预测GGN浸润程度的独立危险因素包括病灶平均直径、平均CT值。Objective To explore the application value of multi-slice spiral CT(MSCT)in in-vasive adenocarcinoma(IAC)and microinvasive adenocarcinoma(MIA)in pulmonary ground-glass nodules(GGN).Methods Clinical data of 80 patients with GGN and underwent surgical treatment in our Imaging Department from June 2018 to November 2023 were collected and ana-lyzed retrospectively.The patients were scanned with multi-slice spiral CT before operation.The images were analyzed by two diagnostic physicians with 3 years and more of working experi-ence.The pathological results were compared.Results Pathologic results showed that 37 of the lesions were IAC and 43 lesions were MIA.There were no significant differences between the two groups in gender,presence of smoking history,location of the lesion,shape of the le-sion,presence or absence of vacuolar sign,and presence or absence of air bronchus sign(P>0.05).There were significant differences in the mean diameter,mean CT value,marginal con-dition,tube bundle sign,vascular perforation sign,pleural depression sign,and nodule type between the two groups(P<0.05).Logistic regression analysis showed that the independent risk factors for GGN included the mean diameter of the lesion and the mean CT value(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that using the mean di-ameter of the lesion≥1.50 cm and the mean CT value≥-491.00 Hu as the cut-off point for identifying IAC and MIA with high sensitivity and specificity.Conclusion The pathological grade of GGN is correlated with its MSCT signs,and the independent risk factors for predicting the degree of GGN infiltration includes the mean diameter of the lesion and the mean CT value.

关 键 词：多层螺旋CT 肺磨玻璃结节 诊断 

分 类 号：R734[医药卫生—肿瘤]