81例恶性肺微小结节的影像学征象分析

Analysis of imaging characteristics of malignant solitary pulmonary nodule

目的:探讨恶性微小孤立性肺结节(SPN)的影像学特征。方法:收集我院门诊就诊经术后病理证实的恶性SPN患者81例,回顾性分析其SPN的影像学特征。结果:81例恶性SPN患者中纯磨玻璃样结节(p GGO)21例,混合性结节(m GGO)24例,实性结节(SN)36例。分叶征及胸膜凹陷征在p GGO中的检出率低于m GGO和SN(χ~2分别为21.13、28.56,均P<0.001),随着结节实性成分增多,密度增高,分叶征及胸膜凹陷征也更明显(趋势χ~2分别为18.64、28.28,均P<0.001)。而毛刺、支气管充气征和血管集束征在3种类型恶性SPN中检出率均较高,但组间差异无统计学意义(P>0.05)。结论:3种类型恶性SPN的影像学特征各有不同,而血管集束征在3种类型恶性SPN中检出率均较高,评判SPN与血管之间的关系对肺微小结节的良恶性鉴别可能更有价值。

Objective To analyze the imaging characteristics of malignant solitary pulmonary nodular（SPN）.Methods There were 81 patients with malignant SPN confirmed by operation and pathology collected in our hospital,and an analysis of their imaging characteristics was performed.Results In the 81 malignant SPN cases,there were 21 cases of pure ground-glass opacity（p GGO）,24 cases of mixed ground-glass opacity（m GGO）,36 cases of solid nodule（SN）.The detection rate of lobulated and pleural retraction sign was lower in p GGO than in m GGO and SN（χ~2 was 21.13,28.56,respectively,P 0.001）.As the solid components of nodules increased,lobulated and pleural retraction sign were more easily observed（trend χ~2 were 18.64,28.28,P0.001）.There were no significant differences in spiculation,air bronchogram and vascular convergence sign between the three types of malignant SPN（P0.05）,and the incidence was high in all the three types.Conclusions The imaging characteristics of the three types of malignant SPN were different,however,the detection rate of vascular convergence sign was high in all the three types.Observing the relationship between SPN and blood vessels is more valuable in differentiating benign and malignant small SPN.