肺微小结节的CT影像学表现及诊断价值

目的 分析肺微小结节（直径≤10 mm）的CT影像学表现，并探讨CT对其定性诊断的价值。方法 回顾性分析2017年3月至2018年11月行手术后经病理检查证实的87例肺微小结节患者共102个肺微小结节的多层螺旋CT征象。结果 102个肺微小结节中，良性组25个、癌前病变组27个、恶性组50个，3组结节的密度、毛刺征、分叶征、血管集束征、胸膜凹陷征发生率差异有统计学意义（P＜0.05）。血管集束征在良性组和癌前病变组主要表现为贴边走形或穿行，无增粗扭曲，而恶性组主要表现为穿行并增粗扭曲，3组血管增厚和走形表现差异有统计学意义（χ²=19.103，P＜0.001）。3组的结节位置、瘤-肺界面情况、空泡征发生情况差异无统计学意义（P＞0.05）。结论 肺微小结节CT影像学表现有一定特征性，ＣＴ在肺微小结节的诊断中有较高的价值。

Characteristics and diagnostic value of CT images of pulmonary micro-nodules

Objective To analyze the characteristics of CT images of micro-nodules(≤10 mm in diameter)and explore their qualitative diagnostic value. Methods Multi-slice spiral CT images of 102 pulmonary micro-nodules in 87 patients with pulmonary micro-nodules,pathologically confirmed from March 2017 to November 2018,were retrospectively analyzed. Results Among 102 pulmonary micro-nodules,25 was included in the benign group,27 in the precancerous group and 50 in the malignant group. The incidence of nodal density,burr sign,lobular sign,vascular bundle sign,and pleural indentation sign of the three groups were statistically significant(P<0.05). Vascular bundle signs in the benign and precancerous groups appeared mainly as clinging or passing through without thickening and distorting,while the malignant group showed mainly passing through with thickening and distorting. There was significant difference in vascular thickening and contouring in the three groups(χ~2=19.103,P<0.001). However,no significant difference was found in the location of nodules,the occurrence of lung-tumor interface,and vacuole sign among the three groups(P>0.05). Conclusions CT images of pulmonary micro-nodules have certain characteristics,and possess important value in the diagnosis of pulmonary micro-nodules.