| 王万勤,刘斌,周勇,等.良恶性肺结节多排CT征象分析[J].安徽医药,2018,22(8):1491-1495. |
| 良恶性肺结节多排CT征象分析 |
| Analysis of the MDCT features of benign and malignant pulmonary nodules |
| 投稿时间：2018-01-31 |
| DOI： |
| 中文关键词: 肺结节 体层摄影术 X线计算机 诊断 鉴别 |
| 英文关键词: Pulmonary nodule Tomography X-ray computed Diagnosis Differentiation |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨不同病理类型[良性、原位癌(AIS)、微浸润腺癌(MIA)及浸润性腺癌(IAC)]肺结节的多排CT(MDCT)影像特征。方法 回顾性分析87例有确切术后病理结果的肺结节MDCT影像资料,把病灶分为良性组22例、早癌组(AIS+MIA)17例和IAC组48例,对三组患者的年龄、性别及肺结节直径、类型、结节形态、结节与肺的交界面、结节的边缘特征、结节与邻近结构的关系、结节与支气管的关系进行对比分析。结果 三组患者的年龄差异无统计学意义,性别比例差异有统计学意义(P<0.05),良性组男性患者居多(68.18%),AIS+MIA及IAC组均以女性患者占优势(分别为70.59%及56.25%)。结节直径三组差异有统计学意义(P<0.001),IAC组>AIS+MIA组[(1.88±0.45) cm比(1.31±0.45) cm,P<0.001],MIA结节直径>AIS[(1.52±0.45)cm比(1.01±0.25) cm,P<0.05]。结节类型三组差异有统计学意义(P<0.001),良性组及IAC组以实性肺结节(SPN)居多(95.45%及75.00%),AIS+MIA组则以纯磨玻璃结节(pGGN)及混合密度的磨玻璃结节(mGGN)为主(分别为47.06%及41.18%)。结节与肺的交界面三组差异有统计学意义(P<0.001),良性组以清楚光整为主(68.18%),AIS+MIA及IAC组以清楚毛糙为主(82.35%及77.08%)。结节的边缘特征(毛刺征)、结节与邻近结构的关系(胸膜凹陷征及血管集束征)、结节与支气管的关系(细支气管充气征及支气管截断征)三组均差异有统计学意义(均P<0.05),且随结节恶性度的增加,上述恶性征象的出现率总体有增加趋势。结论 通过对肺结节直径的测量及对其CT征象的全面细致分析,可有效提高肺结节术前定性诊断的准确率。 |
| 英文摘要: |
| Objective To study the multi detector row computed tomographic(MDCT) features of different pathological types of pulmonary nodules, including benign, adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC). Methods MDCT images of 87 cases of pulmonary nodules with definite postoperative pathologic results were analyzed retrospectively. The lesions were divided into three groups:benign group (22 cases), early adenocarcinoma group [AIS(7 cases) and MIA(10 cases), AIS+MIA(17 cases)], and IAC group (48 cases). The age, gender of the patients, the average diameter, type, shape, edge of the pulmonary nodules, and the MDCT imaging features of the nodule-lung-interface, the relationships between nodule and adjacent structure or bronchia were analyzed. Results Patient age of the three groups had no statistical differences, but sex ratio in each of the three groups was different (P<0.05). Male was the most part (68.18%) in the benign group, whereas more female patients could be found in the AIS+MIA and IAC groups (70.59% and 56.25%, respectively). The average diameters of the pulmonary nodules of the three groups were different (P<0.001). IAC group was larger than AIS+MIA group [(1.88±0.45) cm vs. (1.31±0.45) cm, P<0.001]. We also found that MIA was larger than AIS nodules [(1.52±0.45) cm vs. (1.01±0.25) cm, P<0.05]. Nodule types were different in the three groups (P<0.001). There were mostly solid pulmonary nodules (SPN) in the benign and IAC groups (95.45% and 75.00%), pure ground-glass nodule (pGGN, 47.06%) and mixed ground-glass nodule (mGGN, 41.18%) could often be seen in the AIS + MIA group. There were significant differences in the nodule-lung-interfaces of the three groups (P<0.001). It was mostly clear and smooth in the benign group (68.18%), but clear and irregular in the AIS+MIA and IAC groups (82.35% and 77.08%). CT imaging characteristics of peripheral speculation, pleural indentation, vessel convergence, air-bronchogram, and the bronchi-cutoff sign in the three groups were also statistically significant (all P<0.05), and with the increase of the malignant degree, the appearance rate of these malignant signs had increased overall. Conclusion Through measurement of the diameter of pulmonary nodules, analysis of the CT signs comprehensively and carefully, we can effectively improve the qualitative diagnostic accuracy of the pulmonary nodules before operation. |
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