摘要
目的:探讨生理通气辅助下高分辨率CT(HRCT)靶扫描与薄层CT靶重建在肺磨玻璃样小结节(sGGN)定性诊断中的价值比较.方法:回顾性分析经手术病理证实为肺腺癌的98例孤立性sGGN患者的临床及影像资料,其中不典型腺瘤样增生(AAH)+原位腺癌(AIS)组45例、微浸润性腺癌(MIA)组38例、浸润性腺癌(IAC)组15例.对所有结节均分别按薄层CT靶重建(A方案)及生理通气辅助下HRCT靶扫描(B方案)进行处理,评价图像质量、判断结节类型及统计结节征象、评估诊断信心并给出诊断结果,对阅片结果进行统计学分析.结果:2种方案在AAH+AIS组中的sGGN检出率相仿,但生理通气辅助下HRCT靶扫描在MIA组(P<0.001)和IAC组(P=0.017)中的sGGN检出率均显著高于薄层CT靶重建.生理通气辅助下HRCT靶扫描相较于薄层CT靶重建在密度征(P<0.001)、充气支气管征(P<0.001)、空泡征(P<0.005)及微血管征(P<0.001)等征象判断上有显著差异.生理通气辅助下HRCT靶扫描相较于薄层CT靶重建在肿瘤微血管征分型及与小支气管关系分型的级别上差异具有统计学意义(P<0.005).另外,生理通气辅助下HRCT靶扫描相较于薄层CT靶重建能够显著提升诊断信心及图像质量.结论:生理通气辅助下HRCT靶扫描能提供更好的图像质量和诊断可信度,并能更准确地判断sGGN的征象.
Purpose:To compare the value of physiologically ventilation assisted high resolution CT(HRCT)target scan and thin-slice CT target reconstruction in the qualitative diagnosis of small pulmonary ground glass nodules(sGGN).Methods:The clinical and imaging data of 98 pathologically proven pulmonary adenocarcinoma patients with isolated sGGN were retrospectively analyzed.Patients were divided into three groups:atypical adenomatous hyperplasia(AAH)+adenocarcinoma in situ(AIS)group(n=45),microinvasive adenocarcinoma(MIA)group(n=38)and invasive adenocarcinoma(IAC)group(n=15).All nodules were processed according to two methods:thin-slice CT target reconstruction(plan A)and physiologically ventilation assisted HRCT target scan(plan B).Image quality was evaluated,nodule types were determined,nodule signs were counted,diagnostic confidence was assessed and diagnosis results were made, and the results were statistically analyzed. Results: In AAH+AISgroup, the detection rate of sGGN from plan A or B was similar, but the detection rate of sGGN from physiologicallyventilation assisted HRCT target scan in MIA group (P<0.001) or IAC group (P=0.017) was significantly higher thanthat from thin-slice CT target reconstruction. Physiologically ventilation assisted HRCT target scan showedsignificant differences in the judgment of density signs (P<0.001), aerated bronchial signs (P<0.001), vacuoles (P<0.005) and microvascular signs (P<0.001) compared with thin-layer CT target reconstruction. Physiologicallyventilation assisted HRCT target scan showed a significant difference in the classification of tumor microvascularsigns and the classification of its relationship with bronchi compared with thin-slice CT target reconstruction (P<0.005). In addition, the diagnostic confidence and image quality of physiologically ventilation assisted HRCT targetscanwere significantly improved when compared with thin-slice CT target reconstruction.Conclusion: Physiologically ventilation assisted HRCT target scan can be used to provide better image quality and diagnostic reliability, andjudgethe signs ofsGGNmoreaccurately.
作者
陈琦
朱全新
顾佳伟
王庆荣
王勋
王辉
杨文广
CHEN Qi;ZHU Quanxin;GU Jiawei;WANG Qingrong;WANG Xun;WANG Hui;YANG Wenguang(Department of Radiology,The Third People's Hospital of Kunshan City,Kunshan 215300,China)
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2023年第1期26-31,共6页
Chinese Computed Medical Imaging
基金
苏州市“科教兴卫”青年科技项目(KJXW2021077)
昆山市重点研发计划-社会发展科技专项项目(KS1912)。
关键词
磨玻璃结节
肺腺癌
高分辨率CT靶扫描
生理通气
薄层CT靶重建
Ground glass nodules
Pulmonary adenocarcinoma
High resolution CT target scan
Physiological ventilation
Thin-slice CT target reconstruction
