摘要
目的 分析纯磨玻璃密度结节(p GGN)浸润性肺腺癌MSCT征象及与浸润前病变的鉴别诊断。方法 回顾分析,收集本院2017年9月至2019年12月收治的78例肺腺癌患者的临床资料作为研究对象,均经手术后病理检查确诊。根据2011年肺腺癌分类标准将其分为浸润前病变组49例,包括不典型瘤样增生(AAH)27例,原位腺癌(AIS)22例;浸润性病变组29例,包括微浸润腺癌(MIA)17例,浸润性腺癌(IAC)12例。对患者所得MSCT图像进行分析,并以病理检查结果为基准,计算MSCT对不同类型肺腺癌诊断准确率。结果 MSCT对AAH、AIS、MIA、IAC诊断正确率分别为100%、100%、94.41%、91.66%,与病理检查结果符合率高(P>0.05),浸润前病变与浸润性病变患者病变边缘情况、病变形态、胸膜“凹陷”征、血管“集束”征、病变大小存在明显差异(P<0.05),浸润性病变患者其病变边缘多存在“毛刺”或“分叶”征,病变形态以类圆形为主,出现胸膜“凹陷”征、血管“集束”征情况高于浸润前病变,病变大于浸润前病变为(11.44±5.12)mm。结论 MSCT可为肺腺癌浸润性病变鉴别提供参考依据,病变大、形态不规则、边缘存在“分叶”征/“毛刺”征、胸膜“凹陷”征、血管“集束”征为反映p GGN浸润性的重要指标。
Objective To analyze the MsCT signs of pure ground glass nodule(pGGN) invasive lung adenocarcinoma and its differential diagnosis for pre-invasive lesions. Methods The clinical data of 78 patients with lung adenocarcinoma admitted in our hospital from september 2017 to December 2019 were collected and retrospectively analyzed. They were all diagnosed by pathological examination after surgery. According to the 2011 classification of lung adenocarcinoma, they were divided into 49 cases of pre-invasive lesions, including: 27 cases with adenomatous hyperplasia(AAH), 22 cases with adenocarcinoma in situ(AIs);29 cases with invasive lesions, including 17 cases with micro-invasive adenocarcinoma(MIA), 12 cases with invasive adenocarcinoma(IAC). The Ms CT images of the patients were analyzed. Based on the results of pathological examination, the diagnostic accuracy of Ms CT for different types of lung adenocarcinoma was calculated. Results The accuracy of Ms CT in the diagnosis of AAH, AIs, MIA, and IAC was 100%, 100%, 94.41%, and 91.66%, respectively. It was consistent with the results of pathological examination(P>0.05). There were significant differences in the margins of the lesions, the shape of the lesions, the signs of pleural depression, the vascular bundles, and the size of the lesions between patients with pre-invasive lesions and those with invasive lesions(P<0.05). Patients with invasive lesions often have burrs or lobulation signs in the edges of the lesions. The shape of the lesion was mainly round, and the incidence of pleural depression sign and vascular clustering sign was higher than that in pre-invasive lesions, and the lesion was larger than that in pre-invasive lesions,which was(11.44±5.12)mm. Conclusion Ms CT can provide a reference for the identification of invasive lesions of lung adenocarcinoma. Large lesions, irregular shapes, lobular signs/burr signs in the edges, pleural depression signs, and vascular bundle signs are important indicators of p GGN invasion.
作者
李海艳
韩琨
贾子睿
LI Hai-yan;HAN Kun;JIA Zi-rui(Department of Medical Imaging,North China Petroleum General Hospital,Renqiu 062552,Hebei Province,China;Department of Function,the First Hospital of Langfang Mining Area,North China Petroleum,Langfang 065007,Hebei Province,China;Department of Radiology,the First Hospital of Langfang Mining Area,North China Petroleum,Langfang 065007,Hebei Province,China)
出处
《中国CT和MRI杂志》
2022年第7期40-42,共3页
Chinese Journal of CT and MRI
基金
河北省医学科学研究重点课题计划项目(20170505)。
关键词
纯磨玻璃密度结节
浸润性肺腺癌
MSCT征象
浸润前病变
鉴别诊断
Pure Ground Glass Nodule
Invasive Lung Adenocarcinoma
MSCT Signs
Pre-invasive Lesions
Differential Diagnosis
