摘要
目的探讨cT影像学表现为肺部磨玻璃结节中浸润前病变[不典型腺瘤样增生（AAH）和原位腺癌（AIS）]、微浸润腺癌（MIA）和浸润性腺癌（IAC）的cT表现特征。方法对97例cT影像学表现为肺部磨玻璃结节患者的术前CT图像进行回顾性分析，将病灶分为浸润前病变组（24例）、MIA组（39例）和IAC组（34例），对3组病灶的大小、三维比率、二维比率、实性成分大小、病灶密度、形状、边缘毛刺、边缘分叶、边界情况、内部空泡以及胸膜凹陷进行对比分析。结果浸润前病变均表现为纯磨玻璃结节，多为圆形或类圆形，边界多较清晰；MIA可表现为纯磨玻璃结节或混合密度的磨玻璃结节，也多为圆形或类圆形，边界多较清晰；IAC多为混合密度的磨玻璃结节，不规则形多见。从浸润前病变、MIA至IAC，病灶边缘毛刺、分叶，内部空泡及胸膜凹陷征的比率逐渐增高。MIA组与IAC组的病灶大小、实性成分大小、病灶密度、形状、边缘毛刺、内部空泡和胸膜凹陷的差异均有统计学意义（均P〈0．05）。浸润前病变组与MIA组的实性成分大小和病变密度的差异均有统计学意义（均P〈0．05）。浸润前病变和MIA、MIA和IAC组实性成分的曲线下面积分别为0．705和0．814。结论综合分析磨玻璃结节的CT影像学形态特征，特别是病灶内的实性成分，可对术前诊断和鉴别诊断肺部浸润前病变、MIA和IAC提供帮助。
Objective To explore the CT features of ground-glass nodules （GGN） including preinvasive lesions [ atypical adenomatous hyperplasia （ AAH ） and adenoearcinoma in situ （ AIS ） ], minimally invasive adenocareinoma （MIA） and invasive adenocarcinoma （IAC）. Methods Ninety-seven GGN lesions confirmed by operation pathology were included in this study. The lesions were divided into three groups ： preinvasive lesion group （24 cases）, MIA group （ 39 cases）, IAC group （ 34 cases）. The lesion size, 3-dimensional ratio, 2-dimensional ratio in axial images, lesion density, shape, speculation, lobulation, air-containing space and pleural indentation on the preoperative CT images in the three groups were analyzed and compared with pathological results. The data were statistically analyzed using SPSS 17.0. Results All preinvasive lesions presented as pure GGN on CT image, most showed round-like shape, clear and smooth border. MIA presented as pure GGN or mixed GGN on CT image, most showed round-like shape, with a clear and smooth border. IAC most presented as mixed GGN on CT image, often showed irregular shape. Speculation, lobulation, air-containing space and pleural indentation displayed gradually increasing from preinvasive lesions to MIA and [AC. There were statistically significant differences in lesion size, CT density, shape, air-containing space, speculation, pleural indentation and long diameter of solid component between the MIA and IAC groups （P 〈 0. 05 for all ）. There were st^itistically significant differences in CT density values and long diameters of solid component of the lesions between the preinvasive lesion group and MIA group （P 〈 0.05）. The AUC of solid component of the preinvasive lesion group and MIA group was 0. 705, and that of the MIA and IAC groups was 0. 814. Conclusion Comprehensive analysis of the CT image features of GGNs, especially the solid component in the lesions, may help to the preoperative and differential diagnosis of preinvasive lesions, MIA and IAC.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2014年第3期188-192,共5页
Chinese Journal of Oncology
基金
上海市科委重点基金资助（10411952600）
关键词
肺肿瘤
体层摄影术
x线计算机
诊断
鉴别
磨玻璃结节
Lung neoplasms
Tomography, X-ray computed
Diagnosis, differential
Ground glass nodule
