CT密度直方图对肺内纯磨玻璃样结节病理分级的预测价值

目的 探讨CT密度直方图定量分析对肺内纯磨玻璃样结节(pGGN)病理分级的预测价值.方法 回顾分析经手术病理证实CT表现为pGGN的肺腺癌126例,共128个pGGN病灶的CT影像及病理资料.所有患者均行CT平扫,CT密度直方图定量分析pGGN中密度参数差异所包含的诊断信息,包括平均CT值、最小CT值、最大CT值、中位...

The predictive value of CT density histogram for the pathological grade of purely ground-glass nodules in the lung

Objective To explore the value of quantitative analysis of CT density histogram in predicting the pathological grade of purely ground-glass nodules(pGGN)in the lung.Methods The CT findings of 126 pGGN patients with lung adenocarcinoma confirmed by surgical pathology were retrospectively analyzed.All patients underwent CT plain scanning.The histogram of CT density quantitatively analyzed the diagnostic information contained in the difference of density parameters in pGGN,including average CT value,minimum CT value,maximum CT value,median CT value,skewness and kurtosis.There were 23 cases of atypical adenomatoid hyperplasia(AAH+AIS),34 of orthotopic adenocarcinoma(AIS),31 of micro-invasive adenocarcinoma(MIA)and 40 of invasive adenocarcinoma(IAC).The pGGN density parameters between pre-infiltration lesions and infiltration lesions were compared using independent sample t test.ROC was used to evaluate the pGGN density index to identify pre-invasion and invasive lesions.Results pGGN density index(mean CT value,maximum CT value,skew,kurtosis)was significantly different between pre-invasion lesions and invasive lesions(P<0.05).The difference between the minimum CT value and the median CT value was not statistically significant(P>0.05).Among the histogram parameters of pGGN CT density,the maximum CT value was 0.89(P<0.001),which was a risk factor for pGGN to identify the ROC subsurface area of pre-infiltration lesions and infiltration lesions.The sensitivity of the maximum CT value was the highest(95.8%).Skew specificity was highest(96.5%).Conclusion The difference indexes of average CT value,maximum CT value,skew and kurtosis density obtained by CT density histogram can predict pGGN's pathological grade.