CT影像学检查对肺部磨玻璃样小结节样良、恶性的鉴别诊断价值及影响因素分析

Differential Diagnostic Value and Influencing Factors of CT Imaging Examination in Benign and Malignant Pulmonary Ground-Glass Nodules

目的探究CT影像学检查对肺部磨玻璃样小结节样良、恶性的鉴别诊断价值及影响因素分析。方法搜集并整理2016年2月至2019年2月我院放射科检查的280例肺部磨玻璃样小结节样患者作为研究对象,根据病理结果分为良性组86例与恶性组194例,采用问卷调查获取患者相关资料,患者均行螺旋CT检查,鉴别诊断肺部磨玻璃影,观察两组CT病理诊断与图像特征。结果恶性组年龄高于良性组,具有吸烟史与居住农村的患者多于良性组,CT值大于良性组,差异均具有统计学意义(P<0.05)。CT诊断血管炎4.3%,腺瘤样增生5.7%,炎症23.6%,腺癌17.9%,肺泡细胞癌55.7%,将8例腺癌诊断为腺瘤样增生,诊断准确率97.1%,误诊率2.9%。恶性组胸膜凹陷征、毛刺征、分叶征、空泡征及边界清楚明显多于良性组(P<0.05)。恶性组圆或椭圆少于良性组,而不规则状、斑片状及多结节融合状明显多于良性组(P<0.05)。经Logistic回归分析得出,年龄较大、CT值增加、胸膜凹陷征、毛刺征、分叶征、空泡征是肺部磨玻璃样小结节样恶性独立危险因素(P<0.05)。结论肺部磨玻璃样小结节样恶性主要在年龄较大患者,同时CT影像学检查呈胸膜凹陷征、毛刺征、分叶征、空泡征及CT值增大;而良性患者需进一步根据患者相关情况及临床特征等进行分析。

Objective To investigate the differential diagnosis value and influencing factors of CT imaging in benign and malignant pulmonary ground-glass nodules.Methods A total of 280 patients with pulmonary ground-glass nodules in our Department of Radiology Department from February 2016 to February2019 were selected and classified as research subjects.According to the pathological results,86 patients were classified into a benign group and 194 patients into a malignant group.The questionnaire was applied to obtain the patient-related data.All the patients underwent spiral CT examination to differentially diagnose the pulmona ry ground-glass opacity and observe the CT pathological diagnosis and image features of the two groups.Results The age of the malignant group was higher than that of the benign group;the patients with smoking history and rural residents were more than the benign group;the CT value was higher than that of the benign group(P<0.05).CT diagnosed vasculitis 4.3%,adenomatous hyperplasia 5.7%,inflammation 23.6%,adenoca rcinoma 17.9%,alveolar cell carcinoma55.7%,and 8 cases of adenocarcinoma were diagnosed as adenomatous hyperplasia,the diagnostic accuracy rate was 97.1%,misdiagnosis rate 2.9%.The pleural indentation sign,spicule sign,lobulated sign,vacuole sign and clear boundary of the malignant group were significantly more than those of the benign group(P<0.05).The circle or ellipse in the malignant group was less than those in the benign group,and the irregular,patchy and multi-nodular fusion was significantly more than those in the benign group(P<0.05).Logistic regression analysis showed that older age,increased CT value,pleu ral indentation,spicule sign,lobulated sign,and vacuole sign were independent malignant factors of pulmona ry ground-like nodules(P<0.05).Conclusion The malignant pulmonaryground-glass nodules mainly occurred in older patients.At the same time,CT imaging shows pleural indentation,spicule sign,lobulated sign,vacuole sign and increased CT value.However,benign patients need to be further analyzed based on patient-related conditions and clinical featu res.