肺纯磨玻璃密度不典型腺瘤样增生与微浸润腺癌的CT鉴别诊断

CT differential diagnosis of pure ground glass opacities on atypical adenomatous hyperplasia and minimally invasive adenocarcinoma

目的分析表现为纯磨玻璃密度的肺不典型腺瘤样增生与微浸润腺癌的CT表现及CT对两者鉴别诊断价值。方法回顾性分析经病理证实的16例不典型腺瘤样增生和32例微浸润腺癌的薄层螺旋CT表现,分析薄层螺旋CT中病灶的形态、边缘、内部及邻近结构改变等征象,用χ~2检验进行组间比较。结果薄层CT显示病灶球形度、瘤-肺界面清晰及空泡征对于两者鉴别诊断有意义,组间差异有统计学意义(P均<0.05)。结论不典型腺瘤样增生多呈球形/类球形,微浸润腺癌病灶直径多大于不典型腺瘤样增生,其形态多呈不规则形,瘤-肺界面多清晰且多伴有空泡征。

Objective To analyze the CT features of atypical adenomatous hyperplasia （AAH） and minimal- ly invasive adenocarcinoma （MIA） presented as pure ground-glass opacity and the value of CT in differential diagno- sis. Methods The thin slice CT features of 16 cases AAH and 32 cases of MIA were retrospectively analyzed. Their lesion＇ s shape, margin, internal and adjacent structure change in the thin slice CT were analyzed. Results The le- sion＇ s shape, tumor-lung interface and the vacuole sign had the statistical significance between the two groups （Pall 〈 0. 05 ）. Conclusion AAH is mostly shown spherical, the diameter of the lesions of MIA is larger than AAH, and the MIA lesion mostly shows irregular shape. The tumor-lung interface is clearer and more associated with vacuole sign.