表现为单纯磨玻璃密度结节的肺浸润性腺癌的影像学特征分析

Analysis of Imaging Features of Pulmonary Infiltrating Adenocarcinoma with Pure Ground-glass Nodule

目的:探讨临床影像学上表现为单纯磨玻璃密度结节(pure ground-glass nodule,p GGN)的肺浸润性腺癌的影像学特征。方法:回顾性分析2012年1月-2017年12月于本院进行诊治,并接受胸部多排螺旋CT扫描检查,检查结果提示肺部伴有p GGN的46例患者的一般资料。按照肺癌组织学类型分为浸润性腺癌组(24例)和非浸润性腺癌组(22例)。比较两组病灶大小、密度、病灶周边及内部征象等影像学表现差异。结果:浸润性腺癌组p GGN大小、密度均显著高于非浸润性腺癌组,差异均有统计学意义(P<0.05)。两组p GGN病灶三维比率比较,差异无统计学意义(P>0.05)。浸润性腺癌组p GGN病灶分叶征、血管集束征与非浸润性腺癌组比较,差异均有统计学意义(x^2=25.097、5.502,P<0.05);浸润性腺癌组p GGN病灶毛刺征、空泡征、支气管充气征与非浸润性腺癌组比较,差异均无统计学意义(P>0.05)。结论:结合影像学上p GGN病灶大小、密度以及分叶征、血管集束征象等指标进行综合分析,有助于鉴别浸润性腺癌和AIS、MIA、AAH等非浸润性腺癌,有助于为疾病的早期诊断和患者个体化治疗提供依据。

Objective：To discuss the imaging features of invasive lung adenocarcinoma with pure groundglass nodule（p GGN）.Method：A total of 46 cases with p GGN received the multi-slice spiral CT scanning in our hospital from January 2012 to December 2017 were retrospective analysis,and they were divided into invasive lung adenocarcinoma group（24 cases）and non-invasive lung adenocarcinoma group（22 cases）,according to the histological types confirmed by the pathological results.The focal size,density,peripheral and internal signs were compared between the two groups.Result：The focal size and density in the invasive lung adenocarcinoma group were bigger than those in the non-invasive lung adenocarcinoma group（P〈0.05）.There were no statistical significance in the three-dimensional imaging ratio between the two groups（P〈0.05）.The lobulation sign and vessel convergence sign of p GGN in the invasive lung adenocarcinoma group more than those in the non-invasive lung adenocarcinoma group（ χ2=25.097,5.502,P〈0.05）;there were no statistical significance in the spicule sign,vocule sign and air bronchogram of p GGN in the two groups（P〈0.05）.Conclusion：The comprehensive analysis on the size and density of p GGN and the lobulation sign,vessel convergence sign and others of index are good to make the differential diagnosis of invasive lung adenocarcinoma and non-invasive lung adenocarcinoma（AIS,MIA,AAH）,which it provides the basis in the early diagnosis and individualized treatment.