59例纯磨玻璃结节影像与病理相关因素的定量分析

Imaging-pathological related factors of pure ground glass nodules in lungs:quantitative analyses of 59 cases

目的探讨影像学表现为肺部纯磨玻璃结节(pure ground glass nodules,pGGN)的病理组成,并分析结节内各成分在形成CT值中的作用。方法分析59例pGGN的肺腺癌结节CT值与胶原纤维、弹力纤维、肺泡腔内巨噬细胞含量、肺泡间隔的关系。结果59例pGGN中原位腺癌(adenocarcinoma in situ,AIS)20例、微浸润腺癌(minimally invasive adenocarcinoma,MIA)19例、浸润性腺癌(invasive adenocarcinoma,IAC)20例。其中AIS、MIA、IAC的结节最大截面直径均值分别为(0.73±0.33)、(1.15±0.37)、(1.48±0.46)cm,差异有统计学意义(P<0.05)。AIS的CT均值(-667±114)HU,MIA的CT均值(-634±98)HU,IAC的CT均值(-495±136)HU,三组的CT值差异有统计学意义(P<0.05);CT值与肺泡间隔差异有统计学意义(P<0.05),且呈线性回归关系,系数为正;CT值与肺泡腔内巨噬细胞含量差异有统计学意义(P<0.05),且呈线性回归关系,系数为负。结论pGGN中肺泡间隔及肺泡腔内巨噬细胞含量对CT值的形成可能具有重要作用。

Purpose To quantitatively analyze the pathological components of pure ground glass nodules on lung imaging,and to explore the role of each component in the formation of CT value.Methods Fifty-nine cases of pure ground glass nodules were selected to compare the CT values with the corresponding relationships among the four pathological components,namely collagen fibers,elastic fibers,macrophage content and alveolar septum.Results 59 cases were pure ground glass nodules,including 20 cases of adenocarcinoma in situ(AIC),19 cases of microinvasive adenocarcinoma(MIA)and 20 cases of invasive adenocarcinoma(IAC).The mean values of maximum cross-sectional diameters of AIS,MIA and IAC nodules were(0.73±0.33),(1.15±0.37)and(1.48±0.46)cm,respectively,with statistical significance(P<0.05).The mean CT values of AIS,MIA and IAC were(-667±114),(-634±98),(-495±136)HU(P<0.05),respectively.There was a significant difference between CT value and alveolar septum(P<0.05),with positive linear regression relationship.There was a significant difference between CT value and the content of macrophages in alveolar cavity(P<0.05),with negative linear regression relationship.Conclusion The alveolar septum and macrophage content in pulmonary nodules may play a key role in the formation of CT value in the ground glass nodules.