MRI鉴别诊断表现为磨玻璃结节的早期浸润性肺腺癌

目的 探讨MRI鉴别诊断表现为磨玻璃结节的早期浸润性肺腺癌的价值。方法 回顾性分析34例表现为肺部磨玻璃结节的肺腺癌患者的MRI资料，根据病理结果将其分为非浸润性腺癌组（包括不典型腺瘤样增生、原位腺癌和微浸润性腺癌，n=15）和浸润性腺癌组（n=19）。测量并比较2组病变的最大径、T2WI信号强度和ADC值，绘制ROC曲线，评价其鉴别诊断浸润性腺癌的效能。结果 非浸润性腺癌组病变最大径小于浸润性腺癌组（9.91±2.63）mm vs（13.12±2.71）mm，P<0.01]。非浸润性腺癌组病变T2WI信号强度低于浸润性腺癌组（92.97±8.33 vs 113.57±22.88，P<0.01）。非浸润性腺癌组病变ADC值低于浸润性腺癌组（0.98±0.22）×10^-3 mm²/s vs（1.34±0.31）×10^-3 mm²/s，P=0.01]。ROC曲线分析结果显示，病变最大径诊断浸润性腺癌与非浸润性腺癌的AUC为0.791，临界值为11.52 mm，敏感度为73.72%，特异度为73.33%。结论 病变最大径、T2WI信号强度、ADC值对鉴别诊断表现为磨玻璃结节的浸润性与非浸润性肺腺癌具有一定价值。

MRI differential diagnosis of early-stage lung invasive adenocarcinoma appearing as ground-glass nodule

Objective To investigate value of MRI in differential diagnosis of early-stage invasive lung adenocarcinoma appearing as ground-glass nodule. Methods MRI findings in 34 patients with lung adenocarcinoma appearing as ground-glass nodule were analyzed retrospectively. According to the pathology, the patients were divided into non-invasive adenocarcinoma group (including atypical adenomatous hyperplasia, adenocarcinoma in situ and minimally invasive adenocarcinoma, n=15) and invasive adenocarcinoma group (n=19). The maximum diameter, T2WI signal intensity and ADC value were measured and compared between the 2 groups. ROC curves were used to evaluate the efficacy of differential diagnosis of invasive adenocarcinoma. Results The maximum diameter of lesions in non-invasive adenocarcinoma group was significantly less than that in invasive adenocarcinoma group (9.91±2.63]mm vs13.12±2.71]mm, P<0.01). T2WI signal intensity of lesions in non-invasive adenocarcinoma group was significantly lower than that in invasive adenocarcinoma group (92.97±8.33 vs 113.57±22.88, P<0.01). ADC value in non-invasive adenocarcinoma group was also significantly lower than that in invasive adenocarcinoma group (0.98±0.22]×10^-3 mm²/s vs1.34±0.31]×10^-3 mm²/s, P=0.01). ROC curve showed that the AUC of the maximum diameter was the highest, which value was 0.791, and the optimal cut-off value was 11.52 mm, with sensitivity of 73.72%, specificity of 73.33%. Conclusion The maximum diameter, T2WI signal intensity and ADC value are valuable for differential diagnosis of lung invasive adenocarcinoma from non-invasive lesions.