持续存在的肺部磨玻璃结节CT征象及随访分析

Character of imaging and follow-up examination in persistent ground-glass opacities on CT scan

目的探讨基线CT征象及随访在鉴别持续存在的肺部磨玻璃结节良恶性中的诊断价值。方法回顾性分析2011年3月~2016年3月经我院随访并最终得到手术病理证实的肺部磨玻璃结节共51例,随访时间≥3个月,参照2011年版肺腺癌病理新分类将结节分为良性组和恶性组,分析各组结节基线大小、内部/边缘征象以及随访过程中结节的变化。结果 51例入组病例中包括良性组17例,恶性组34例,基线扫描5~10mm及11~15mm区间良恶性结节大小差异有统计学意义(P<0.05),而内部/边缘征象差异无统计学意义(P<0.05)。良性组随访时间为(256.82±212.44)天,恶性组随访时间为(563.59±567.47)天,差异有统计学意义(P<0.05)。良性组在随访过程中表现有增长的病例为2例,恶性组为18例,随访增长比例差异有明显统计学意义(P<0.05)。结论持续存在磨玻璃结节初诊多无明确的征象特异性,大小可作为结节良恶性鉴别的参考之一,随访管理是此类病变早期诊治的重要内容,适当的随访能够很大程度为病变的鉴别提供重要参考意见。

Objective To analyze the value of baseline CT manifestations and follow-up examination in persistent pulmonary ground-glass opacity （GGO） with different pathological types. Methods Baseline CT features and changes during follow-up of 51 patients with 51 lesions who underwent curative resection from March 2011 to March 2016 were retrospectively analyzed. Follow-up period lasted at least 3 months for each patient. All lesions were divided into benign and malignant groups according to the international muhidisciplinary classification of lung adenocarcinoma. Results 51 cases in the group included 17 cases of benign lesions and 34 cases of malignant Lesions. There were no statistical differences in CT features between two groups, however, statistical difference of sizes in the ranges of 5 - 10 mm and 11 - 15 mm was significant. Follow-up time of malignant group was longer than the benign group. 2 cases of benign group changed in CT features based on baseline CT scan. 18 cases changed in malignant group. Data were significantly different on the change ratio between two groups. Conclusion There is no definite specificity of CT features on baseline CT scan of persistent GGO. Size can be one of the reference for the differentiation between benign and malignancy nodules. Follow-up management is an important mean for this kind of lesions. An appropriate follow-up examination can provide an important point of reference in differential diagnosis.