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肺内磨玻璃结节CT特征与病理结果相关性分析 被引量:25

Correlation analysis of CT characteristics and pathological results of lung ground-glass nodule
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摘要 目的观察肺内磨玻璃结节的CT征象并评分,分析CT征象及评分对肺内磨玻璃结节定性诊断的价值。方法回顾性分析经病理及随访证实的44例肺内磨玻璃结节的CT图像,观察磨玻璃结节的CT征象并进行评分,所观察的CT征象包括磨玻璃结节密度(纯磨玻璃结节或者混杂密度磨玻璃结节)、分叶征、毛刺征、空泡征、血管集束征、胸膜凹陷征、微血管征、结节大小、结节内实性成分大小、随访变化等。分析CT征象及评分与病理结果的相关性。用四格表卡方检验评价各CT征象预测病理结果的灵敏度、特异度、阳性预测值、阴性预测值。结果 44例磨玻璃结节中,癌前病变21例、微浸润癌15例、炎性病变8例,原位癌评分1.5~9,平均4.3;微浸润癌评分1.5~9,平均5.4;炎症评分2~8,平均3.3。大部分CT征象灵敏度较高,特异度、阳性预测值、阴性预测值较差。21例原位癌15例发现后行手术切除,5例分别随访3月、6月后未见明显变化行手术切除,1例随访5年后未见明显变化行手术切除;15例微浸润癌10例发现后行手术切除,3例分别随访3月、6月后未见明显变化行手术切除,2例分别随访22月、5年后轻度增大行手术切除;7例炎性结节随访后变小或者消失,1例随访3月后未见变化行手术切除。结论磨玻璃结节CT征象与病理结果相关性较差,随访观察对诊断具有重要临床价值。 Objective To observe the CT features of lung ground-glass nodule(GGN) and to evaluate the value of CT features and scoring in the qualitative diagnosis of lung GGN. Methods A retrospective analysis of CT images was made in 44 cases with pathologically proved pulmonary ground glass nodules. CT features,including ground glass nodules density( pure or part-solid ground glass nodules),lobulation,spiculation,vacuole sign,hair vascularconvergence sign,pleural indentation,microvascular syndrome,nodule size and the solid component size,follow-up changes,were observed and scores were made. The correlation between CT feathers and pathological findings was analyzed. The sensitivity,specificity,positive predictive value and negative predictive value of each CT feather were evaluated by chi-square test. Results There were 21 cases of carcinoma in situ,15 cases of micro-invasive carcinoma,8 cases of inflammatory lesions. The average score of carcinoma in situ,micro-invasive carcinoma,inflammation were 4. 3,5. 4,3. 3,respectively. The sensitivity of most CT feathers was high,while the specificity,positive predictive value and negative predictive value were poor. There were 15 cases of carcinoma in situ underwent surgical resection without follow-up,5 cases without change after 3 or 6 months follow-up and 1 case after 5-year follow-up underwent surgical resection. There were 10 cases of micro-invasive carcinoma underwent surgical resection without follow-up,3 cases without change after 3-month follow-up underwent surgical resection. 2 cases underwent surgical resection after 22 months or 5 years( increased in size),respectively. 7 cases of inflammatory nodules were smaller or disappeared after 3-month follow-up,1 case without change after 3-month follow-up underwent surgical resection. Conclusion There is a poor correlation between CT feathers of GGN and pathological findings. The follow-up observation has important clinical value in diagnosis.
作者 王海燕 柳澄 孙丛 李宁 WANG Haiyan;LIU Cheng;SUN Cong;LI Ning(Shandong Medical Imaging Research Institute Affiliation to Shandong University,Jinan 250021,P.R.China)
出处 《医学影像学杂志》 2018年第6期936-940,共5页 Journal of Medical Imaging
关键词 肺磨玻璃结节 癌前病变 肺腺癌 浸润性腺癌 体层摄影术 X线计算机 Pulmonary ground glass nodules Lung adenocarcinoma Invasive lesions Tomography X-ray computed
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