CT鉴别诊断纯磨玻璃密度结节下肺浸润前病变与微浸润腺癌的价值
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摘要
目的研究CT鉴别诊断纯磨玻璃密度结节下肺浸润前病变(PIL)与微浸润腺癌(MIA)的价值。方法选取2017年8月至2018年7月经本院手术病理证实且CT图像表现为纯磨玻璃密度结节的患者100例为研究对象,其中PIL患者62例(PIL组)、MIA患者38例(MIA组)。比较两组的CT征象、病理特点、病灶直径和CT值。结果两组的形态、边缘形态、界面清晰度、支气管充气征等CT征象检出率存在显著差异(P<0.05)。PIL组的非泡壁播散、周围(交界处)瘀血水肿检出率高于MIA组,背景炎症检出率低于MIA组(P<0.05)。PIL组的病灶直径小于MIA组,CT值低于MIA组(P<0.05)。结论 CT检查根据CT征象、病理特点、病灶相关指标可对纯磨玻璃密度结节下PIL、MIA进行准确地鉴别诊断。
Objective To study the value of CT in differential diagnosis of preinvasive lesion(PIL) and minimally invasive adenocarcinoma(MIA) of pure ground-glass nodule. Methods From August 2017 to July 2018, 100 patients confirmed by surgery and pathology in our hospital and the CT images showed pure ground-glass nodule were selected as the study objects.Among them, there were 62 patients with PIL(PIL group) and 38 patients with MIA(MIA group). The CT signs, pathological features, lesion diameter and CT value were compared between the two groups. Results There were significant differences in the detection rate of CT signs such as shape, edge shape, interface clarity and bronchial inflation sign between the two groups(P<0.05). The detection rate of non-vesicular wall dissemination, peripheral(junction) blood stasis and edema in the PIL group were higher than those in the MIA group, and the detection rate of background inflammation was lower than that in the MIA group(P<0.05). The diameter of lesions in the PIL group was smaller than that in the MIA group, and the CT value was lower than that in the MIA group(P<0.05). Conclusion CT examination can accurately differentiate PIL and MIA of pure ground-glass nodule according to CT signs, pathological characteristics and related indicators of lesions.
Objective To study the value of CT in differential diagnosis of preinvasive lesion(PIL) and minimally invasive adenocarcinoma(MIA) of pure ground-glass nodule. Methods From August 2017 to July 2018, 100 patients confirmed by surgery and pathology in our hospital and the CT images showed pure ground-glass nodule were selected as the study objects.Among them, there were 62 patients with PIL(PIL group) and 38 patients with MIA(MIA group). The CT signs, pathological features, lesion diameter and CT value were compared between the two groups. Results There were significant differences in the detection rate of CT signs such as shape, edge shape, interface clarity and bronchial inflation sign between the two groups(P<0.05). The detection rate of non-vesicular wall dissemination, peripheral(junction) blood stasis and edema in the PIL group were higher than those in the MIA group, and the detection rate of background inflammation was lower than that in the MIA group(P<0.05). The diameter of lesions in the PIL group was smaller than that in the MIA group, and the CT value was lower than that in the MIA group(P<0.05). Conclusion CT examination can accurately differentiate PIL and MIA of pure ground-glass nodule according to CT signs, pathological characteristics and related indicators of lesions.
引文
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[2]戈霞晖,管雯斌,韩锋锋,等.表现为肺部磨玻璃结节的浸润前病变和浸润性腺癌的CT及病理对比研究[J].中国呼吸与危重监护杂志,2017,16(6):561-566.
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[4]秦福兵,陆友金.纯磨玻璃结节定量CT鉴别肺浸润性腺癌与浸润前病变和微浸润腺癌[J].中国医学计算机成像杂志,2016,22(1):22-26.
[5]王阳.CT表现为肺磨玻璃结节的炎症、浸润前与浸润性腺癌的鉴别诊断研究[D].大连:大连医科大学,2016.
[6]左玉强,田云霞,王黎,等.肺浸润前病变与微浸润腺癌的CT鉴别诊断[J].山东医药,2016,56(3):84-85.
[7]赵丰平.多排螺旋CT对浸润性肺腺癌与浸润前病变的CT鉴别诊断[J].中外医疗,2015,34(24):174-175.
[8]王晓野.肺纯磨玻璃密度结节在微浸润腺癌与浸润前病变中MSCT的诊断价值研究[D].大连:大连医科大学,2015.