肺磨玻璃结节HRCT影像特征与肺腺癌病理分型的相关性研究

目的分析肺部磨玻璃密度结节(GGN)在HRCT的影像特征,并与肺腺癌病理分型进行相关性对照,以评价HRCT在肺腺癌病理学分型鉴别诊断中的价值,为肺癌的临床治疗提供依据。方法收集肺部GGN并经病理证实的患者,分析GGN的影像学特征,包括病灶大小(平均径)、CT值(平均CT值和相对CT值)、病灶形态、边缘、界面、内部结构(空泡征、支气管截断征)及邻近结构(胸膜凹陷征及血管集束征)改变等,并与病理分型及亚型进行对照。结果GGN的HRCT征象中,病灶边缘、界面、内部结构(空泡征、支气管截断征)及邻近结构(胸膜凹陷征、血管集束征)在四组间的差异具有统计学意义(P<0.05)。按肺腺癌病理亚型分类,附壁型腺癌、腺泡型腺癌、乳头型腺癌三组在空泡征、血管集束征、CT值(平均CT值和相对CT值)差异有统计学意义(P<0.05)。结论GGN的HRCT影像特征可以作为AAH、AIS、MIA与IAC鉴别诊断的可靠依据。此外,空泡征、血管集束征、平均CT值和相对CT值可为IAC病理亚型的分型提供参考。

Correlation between HRCT image features of lung ground-glass nodules and histological type of lung adenocarcinoma

Objective The study is to analyze the image features of high resolution CT(HRCT)on pulmonary ground-glass nodules and to compare with histological type of lung adenocarcinoma.To assess the valuable effection of HRCT on differential diagnosis of histological type in lung adenocarcinoma and provide a theoretical basis for the treatment of lung adenocarcinoma.Methods The chest CT examination was performed in our hospital from October 2015 to October 2018.In addition,HRCT detected at least one pathologically confirmed with GGN in the lungs,and a total of 129 patients were included.There were 42 males and 87 females with an average age of 56.8 years.Signs include lesion size(mean diameter),CT value(average CT value and relative CT value),lesion morphology,margin,interface,internal structure(vocule sign,bronchial truncation)and adjacent structures(pleural concavity,vessel convergence).Above of HRCT image features were compared with the pathological results and pathological subtype.Results The difference between the four groups were statistically significant in lesion margin,interface,internal structure(vocule sign,bronchial truncation)and adjacent structures(pleural concavity,vessel convergence)(P<0.05).According to the pathological subtype of lung adenocarcinoma,(lepidic type,acinar type,papilla type)were found statistically significant in vocule sign,vessel convergence and CT value(average CT value and relative CT value)(P<0.05).Conclusion The HRCT image features of GGN can be used as a reliable basis for the differential diagnosis of AAH,AIS,MIA and IAC.In addition,vocule sign and vessel convergence,average CT value and relative CT value differences can be used as an important reference to identify IAC pathological subtype.