CT在鉴别肺良恶性磨玻璃样病变中的应用价值

The Value of CT in Differentiating Pulmonary Benign and Malignant Ground Glass Lesions

目的 探索CT特征在鉴别肺良恶性磨玻璃样病变（ground glass opacity,GGO）中的价值.方法 回顾性分析2016年1月—2017年12月中国医科大学附属第四医院胸外科收治的CT表现为GGO的患者140例.分析GGO的大小、形状、内部是否含有空泡、穿过结节的血管走行、CT值等指标.结果 术后病理结果为良性病变的54例,病理结果为恶性的86例患者中：AIS 46例,MIA 40例.良性组平均CT值（-674.50±50.40）HU,AIS组平均CT值为（-652.50±56.40）HU,MIA组的CT值为（-598.52±79.20）HU,P=0.001;良性组的最大径为（0.60±0.28）cm,AIS组的最大径为（0.80±0.34）cm,MIA的最大径为（1.10±0.23）cm,P=0.005;平均CT值、结节最大径、血管在结节中走行（穿过结节中血管是否增粗）、结节性质（圆形、类圆形及其他）及空泡征在良恶性两组中差异有统计学意义.结论 结合结节最大径、平均CT值、结节中血管走行、结节的形状、空泡征等可以鉴别GGO的良恶性.

Objective To explore the value of CT features in differentiating pulmonary benign and malignant ground glass opacity （GGO）. Methods 140 cases of GGO with CT findings in thoracic surgery of the Fourth Affiliated Hospital of China Medical University were retrospectively analyzed from January 2016 to December 2017. The size, shape, internal vacuole and CT value of GGO were analyzed. Results The pathological results were benign in 54 cases and malignant in 86 cases including 46 patients with AIS and 40 patients with MIA. The mean CT value of benign group was （-674.50 ±50.40） HU, the average CT value of AIS group was （-652.50 ± 56.40） HU and （-598.52 ±79.20） HU in the MIA group. The maximum diameter of benign group was about （0.60 ± 0.28） cm. The maximum diameter of AIS group was （0.80 ± 0.34） cm and MIA group was about （1.10 ± 0.23） cm. There were significant differences between benign and malignant groups in the path of blood vessels （whether the vessels were thicker or not through the nodules）, the nodular nature （round, round and other） and vacuole sign in the two groups. Conclusion Combined with the maximum diameter of the nodules, mean CT value, the flow of vessels in the nodules, the shape of the nodules, vacuole sign and so on, the benign and malignant GGO can be distinguished.