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

Value of CT Imaging in Differential Diagnosis of Benign and Malignant Pulmonary Ground Glass Nodules and Analysis of Influencing Factors

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。方法:选肺部磨玻璃样小结节样患者60例(2019年1月-2020年12月),经病理结果,分良性组(n=18例)和恶性组(n=42例),调查其基本资料,并予CT影像学检查,分析鉴别诊断价值及影响因素。结果:两组性别相比,无明显差异(P>0.05),两组年龄、吸烟史、居住地、CT值相比,存在明显差异(P<0.05)。60例患者,视病理诊断为金标准,CT诊断准确率为86.67%(52/60),误诊率为13.33%(8/60)。恶性组胸膜凹陷征、毛刺征、分叶征、空泡征、边界清楚率均高于良性组,存在明显差异(P<0.05)。恶性组圆或椭圆、不规则状、斑片状、多结节融合状均高于良性组,存在明显差异(P<0.05)。经Logistic回归分析得出,肺部磨玻璃样小结节样良、恶性影响因素有年龄、CT值、胸膜凹陷征、毛刺征、分叶征、空泡征等(P<0.05)。结论:肺部磨玻璃样小结节样良性患者,需根据相关情况及临床特征进行分析;而恶性患者主要存在年龄较大的患者,且其CT影像学检查呈胸膜凹陷征、毛刺征、分叶征、空泡征及CT值增加。

Objective:To explore the value and imaging factors of CT imaging in the differential diagnosis of benign and malignant pulmonary ground glass nodules.Methods:60 patients with pulmonary ground glass nodules(January 2019 to December 2020)were selected.According to the pathological results,they were divided into benign group(n=18 cases)and malignant group(n=42 cases).The basic data were investigated,and CT imaging was performed to analyze the value of differential diagnosis and influencing factors.Results:there was no significant difference between the two groups in gender(P>0.05).There were significant differences in age,smoking history,residence and CT value between the two groups(P<0.05).The diagnostic accuracy of CT was 86.67%(52/60),and the misdiagnosis rate was 13.33%(8/60).The rates of pleural depression sign,burr sign,lobulation sign,vacuole sign and clear boundary in malignant group were significantly higher than those in benign group(P<0.05).Round or oval,irregular,patchy and multi nodule fusion in malignant group were significantly higher than those in benign group(P<0.05).Logistic regression analysis showed that the influencing factors of benign and malignant pulmonary ground glass nodules were age,CT value,pleural depression sign,burr sign,lobulation sign,vacuole sign and so on(P<0.05).Conclusion:patients with benign pulmonary ground glass nodules should be analyzed according to relevant conditions and clinical characteristics;The malignant patients were mainly older patients,and their CT imaging showed pleural depression sign,hairpin sign,lobulation sign,vacuole sign and increased CT value.