摘要
目的分析肺部纯磨玻璃结节(pGGN)侵袭性肺腺癌诊断中CT影像学特征应用的价值。方法回顾性分析本院2015年-2017年40例经手术病理证实为侵袭性肺腺癌且CT表现为pGGN,其中微浸润性腺癌(MIA)24例和浸润性腺癌(IAC)16例,应用CT观察患者病变大小、密度、边缘及临近结构等影像学特征并统计平均CT值,采用受试者操作特征(ROC)曲线评估病灶大小及平均CT值在pGGN侵袭性肺腺癌中的诊断价值。结果 IAC组存在不规则形、毛刺征、分叶征、血管集束征、空气支气管征均显著高于MIA组(P<0.05);两组pGGN病变大小及平均CT值间比较差异具有统计学意义(P<0.05);经ROC曲线分析,病变大小预测IAC最佳界限值为18.45mm,诊断的AUC面积为0.808,灵敏度、特异度、约登指数分别为66.70%、88.00%、0.547;平均CT值预测IAC最佳界限值为-534.05Hu,诊断的AUC面积为0.856,灵敏度、特异度、约登指数分别为80.00%、84.00%、0.640,其中平均CT值诊断价值较病变大小高。结论在肺部pGGN侵袭性肺腺癌诊断中应用CT影像学特征可有效鉴别MIA与IAC,其中平均CT值诊断价值较高,当pGGN表现为不规则形,并伴有毛刺征、分叶征、血管集束征、空气支气管征时,IAC可能性较大,可为临床诊治提供参考价值。
Objective To analyze the value of CT imaging features in the diagnosis of pulmonary pure ground glass nodule(pGGN)invasive adenocarcinoma.Methods 40 cases of invasive lung adenocarcinoma patients confirmed by surgical pathology and whose CT showed pGGN from 2015 to 2017 in our hospital were retrospectively analyzed,among them,there were 24 cases of micro invasive adenocarcinoma(MIA)and 16 cases of invasive adenocarcinoma(IAC),the imaging features such as lesion size,density,edge and adjacent structures of the lesions were observed by CT and the average CT value were calculated,receiver operational characteristic(ROC)curve was used to assess the values of lesions size and average CT value in the diagnosis of pGGN invasive lung adenocarcinoma.Results The presences of irregular shape,burr sign,lobulation sign,vascular cluster sign and air bronchial sign in IAC group were significantly higher than those in MIA group(P<0.05),the difference of pGGN lesion size and average CT value between the two groups was statistically significant(P<0.05).ROC curve analysis showed that the best limit value of lesion size for predicting IAC was 18.45 mm,AUC was 0.808,sensitivity,specificity and Jordan index was 66.70%,88.00%and 0.547,respectively;the best limit value of average CT value for predicting IAC was-534.05 Hu,AUC was 0.856,sensitivity,specificity and Jordan index was 80.00%,84.00%and 0.640,respectively,the diagnostic value of average CT value is higher than that of the lesion size.Conclusion CT imaging features can be used to identify MIA and IAC in the diagnosis of pulmonary pGGN invasive adenocarcinoma,the average CT value has higher diagnostic value,IAC is more likely when pGGGN is irregular,accompanied by burr sign,lobulation sign,vascular cluster sign and air bronchial sign,it can provide reference value for clinical diagnosis and treatment.
作者
罗继元
万青松
王志明
刘威
杨科
LUO Ji-yuan;WAN Qing-song;WANG Zhi-ming(Department of Radiology,Panzhihua General Hospital,Panzhihua 617023,Sichuan Province,China)
出处
《中国CT和MRI杂志》
2019年第8期57-60,共4页
Chinese Journal of CT and MRI
关键词
纯磨玻璃结节
侵袭性
微浸润性腺癌
浸润性腺癌
Pure Ground Glass Nodule
Invasiveness
Micro Invasive Adenocarcinoma
Invasive Adenocarcinoma
