肺结节大小和密度测量在AIS精准判断中的价值

The Value of Llung Nodule Size and Density in AIS Precise Judgment

目的探讨肺结节大小和密度测量方法学的差异及其在肺原位腺癌(lung adenocarcinomainsitu,AIS)精准判断中的价值,主要分析病灶的大小和密度。方法将97例手术病理为肺AIS的患者纳入本研究(其中3例为两灶),女性63例,男性34例,平均年龄(50.3±12.0)岁。结果纯磨玻璃结节81灶(81.0%,81/100);混合磨玻璃结节19灶,表现为pGGN的肺AIS,其最大径与平均径均小于表现为mGGN的肺AIS。密度均匀pGGN的平均CT值是(-637.2±101.5)HU;密度不均匀pGGN的平均CT值是(-566.7±99.8)H U,其中代表性区域平均C T值是(-438.6±117.2)HU。81个pGGN的平均CT值是(-599.7±106.1)HU。结论肺AIS的判断主要依据是病灶的大小和密度。同为肺AIS,表现为pGGN的要小于表现为mGGN。密度测量主要针对磨玻璃成分,表现为较均匀磨玻璃密度的AIS其密度值更低,表现为不均匀磨玻璃密度的AIS其平均密度高于前者,其中较高密度部分为区分是否有侵袭性成分提供基础。

Objective To explore the methodological difference in lung nodule size and density measurement and its value in accurate diagnosis of lung adenocarcinoma in situ. Methods 97 patients 63 females, 34 males, age ranged from 24 to 79yrs, mean （50.3±12.0）yrs, with lung adenocarcinoma in situ lesions confirmed by operation pathology were included in this study. All the cases were performed ultra-high-resolution computed tomography before operation. Results 100 cases of lung AIS, including 81 pure ground-glass nodules and 19 mixed ground-glass nodules. The maximum and average diameter of pGGNs were smaller than mGGN in lung AIS. In mGGN, the maximal diameter of solid component was （4.2±1.4）mm, the average diameter of solid component was （3.7±1.2）mm. The average CT value of homogeneous pGGNs were （-637.2±101.5）HU, inhomogeneous pGGNs were （-566.7±99.8）HU, the average CT value of the representative region in it is （-438.6±117.2）HU. The average CT value of the 81 pGGN was （-599.7±106.1）HU. Conclusion The lesions of lung AIS were judged mainly by the size and density of the lesion. The pGGNs were smaller than mGGNs in lung AIS. The average CT value in homogeneous AIS lesions were lower than inhomogeneous lesions, the higher density section provides the basis for distinguishing aggressive components.