高分辨率CT对10mm以下肺纯磨玻璃密度结节的良恶性鉴别诊断

HRCT Differential Diagnoses of Pulmonary Benign Nodules and Malignant Nodules Presenting as Pure Ground-Glass Nodules less than 10 mm in Diameter

目的 探讨高分辨率CT（HRCT）对直径10 mm以下良、恶性肺纯磨玻璃密度结节（pGGN）的鉴别诊断价值.方法 回顾性分析198例经手术病理证实且HRCT表现为直径10 mm以下pGGN患者的影像资料,包括病灶的部位、最大径、瘤肺界面、病灶密度及内部特征等.对良、恶性pGGN的HRCT表现之间的差异进行统计学分析.结果 198例中,良性和恶性pGGN分别为23例和175例.良性组及恶性组的性别、年龄构成及有无吸烟史之间的差异均无统计学意义（P〉0.05）.恶性pGGN相较于良性者更多表现为不均质CT值病灶（P=0.031）.而良、恶性pGGN的发生部位、最大径、平均CT值、瘤肺界面、浅分叶、毛刺、胸膜牵拉、空泡、空气支气管征、小血管改变等之间的差异无统计学意义（P〉0.05）.结论 HRCT对直径10 mm以下肺pGGN的良、恶性鉴别具有一定诊断价值.

Objective To investigate the HRCT findings of benign and malignant nodules of the lung presenting as pure ground-glass nodules （pGGNs）, and to explore their differential diagnoses on HRCT images. Methods A retrospective analysis of HRCT images of 198 cases of pGGNs less than 10 mm in diameter with pathological results was performed. The location, size, tumor-lung interface, density characteristics were statistically analyzed. Results There were 23 cases of benign nodules and 175 cases of malignant nodules respectively. No significant difference was found in gender, age, and smoker history between benign and malignant nodules （P 〉 0.05）. Malignant pGGNs less than 10 mm in diameter had a higher frequency to demonstrate as a heterogeneity nodule than benign ones （P=0.031）. There were no statistically significant differences in the location, size, mean CT value, tumor-lung interface, lobulation, spiculation, pleura traction, vacuole sign, air bronchogram, and vessel changes between the two groups （P 〉 0.05）. Conclusion HRCT is helpful in the differential diagnoses of pulmonary benign and malignant nodules presenting as pGGNs less than 10 mm in diameter.