CT定量参数对50个肺磨玻璃结节侵袭性的评估价值分析

Analysis of evaluation value of quantitative CT parameters on invasiveness of 50 cases of pulmonary ground glass nodules

[目的]探讨CT定量参数在预测肺磨玻璃结节侵袭性中的诊断价值.[方法]回顾性分析43例经手术病理检查证实的50个磨玻璃结节CT靶扫描图像.根据病理检查结果将50个结节分为A组(非侵袭性病变组)和B组(侵袭性病变组),测量两组肺磨玻璃结节的长径、宽径、高径及平均CT值,并计算病灶相应的二维平均大小、三维平均大小、体积及质量.利用单因素及二元Logistic回归对肺磨玻璃结节侵袭性的独立危险因素进行分析.[结果]单因素分析结果显示,两组长径、宽径、高径、平均CT值、二维平均大小、三维平均大小、体积及质量间差异均具有统计学意义(P<0.05).二元Logistic回归分析结果显示,肺磨玻璃结节的质量(OR=4.611,95%CI:1.198~17.746,P=0.026)是预测磨玻璃结节样侵袭性肺腺癌的独立危险因素,ROC分析结果显示质量的最佳临界点是0.561 g,曲线下面积为0.723,P=0.007,敏感度为53.80%,特异性为91.70%.[结论]CT定量参数可为评估肺磨玻璃结节的病理侵袭性提供参考依据,质量参数为预测肺磨玻璃结节侵袭性的独立影响因素.

OBJECTIVE To explore the diagnostic value of quantitative CT parameters in predicting the invasiveness of pulmonary ground glass nodules.METHODS The CT target scan images of 50 ground glass nodules confirmed by surgical and pathological examination in 43 cases were retrospectively analyzed.According to the pathological examination results,50 nodules were divided into group A(non-invasive lesion group)and group B(invasive lesion group).The long diameter,wide diameter,height diameter and average CT value of pulmonary ground glass nodules in the two groups were measured,and the corresponding two-dimensional average size,three-dimensional average size,volume and mass of the lesions were calculated.Univariate and binary Logistic regression were used to analyze the independent risk factors for the invasiveness of ground glass nodules.RESULTS The results of univariate analysis showed that there were significant differences in long diameter,wide diameter,height diameter,average CT value,two-dimensional average size,three-dimensional average size,volume and mass between the two groups(P<0.05).Binary Logistic regression analysis showed that the mass of pulmonary ground glass nodules(OR=4.611,95%CI:1.198-17.746,P=0.026)was an independent risk factor for the prediction of nodular invasive lung adenocarcinoma of ground glass nodules.The results of ROC analysis showed that the optimal critical point of mass was 0.561 g,the area under the curve was 0.723,P=0.007,the sensitivity was 53.80%,and the specificity was 91.70%.CONCLUSION The quantitative CT parameter can provide a reference for evaluating pathological invasiveness of pulmonary ground glass nodules,and mass parameters are independent influencing factors for predicting the invasiveness of pulmonary ground glass nodules.