CT扫描在肺部磨玻璃样结节良恶性鉴别中的应用价值及影响因素分析

Application Value and Influencing Factors of CT Scanning in the Differentiation of Benign and Malignant Ground-glass Nodules in Lung

目的分析多层螺旋CT检查对良恶性肺部磨玻璃样结节(ground glass nodule,GGN)的应用价值以及针对结节良恶性的影响因素分析。方法回顾性分析2019年10月—2022年10月新沂市中医医院收治的经多层螺旋CT发现有肺部GGN的81例患者资料,经手术病理结果(83个结节)分为良性病变组(7例,7个结节)和恶性病变组(74例,76个结节),收集整理相关临床及影像资料,分析两组CT影像特征及影响因素。结果两组在年龄、吸烟史、恶性肿瘤家族史、CT值以及毛刺征、空泡征、分叶征、胸膜凹陷征、血管集束征、支气管充气征方面比较,差异有统计学意义(P<0.05)。年龄、吸烟史、CT值以及毛刺征、空泡征、分叶征、胸膜凹陷征、血管集束征均是恶性肺GGN的独立危险因素(OR=6.135、2.284、5.068、4.076、3.347、5.507、3.662、3.564,P<0.05)。结论年龄、吸烟史、毛刺征、空泡征、分叶征、胸膜凹陷征、血管集束征和CT值对良恶性肺CGN的辨别有一定的应用价值,而部分良性肺GGN需进一步结合患者情况和其他辅助检查等综合判断。

Objective Analyze the application value of multi-slice spiral CT examination for benign and malignant ground glass nodules(GGN)in the lungs,and analyze the influencing factors for benign and malignant nodules.Methods A retrospective analysis was conducted on the data of 81 patients with pulmonary GGN detected by multi-slice spiral CT admitted to Xinyi Traditional Chinese Medicine Hospital from October 2019 to October 2022.According to surgical and pathological results(83 nodules),they were divided into a benign lesion group(7 cases,7 nodules)and a malignant lesion group(74 cases,76 nodules).Relevant clinical and imaging data were collected and organized,and the CT imaging characteristics and influencing factors of the two groups were analyzed.Results There were statistically significant differences between the two groups in age,smoking history,family history of malignant tumor,CT value,burr sign,vacuole sign,lobulation sign,pleural indentation sign,blood vessel cluster sign,and bronchial inflation sign(P<0.05).Age,smoking history,CT values,as well as spicule sign,vacuole sign,lobulation sign,pleural indentation sign,and vascular bundle sign are independent risk factors for malignant pulmonary GGN(OR=6.135,2.284,5.068,4.076,3.347,5.507,3.662,3.564,P<0.05).Conclusion Age,smoking history,spicule sign,vacuole sign,lobulation sign,pleural indentation sign,vascular bundle sign,and CT value have certain practical value in distinguishing benign and malignant lung CGN,while some benign lung GGN needs to be further judged in combination with patient conditions and other auxiliary examinations.