肺磨玻璃结节的胸部CT影像特征及其对结节良恶性的诊断价值

CT imaging features of ground glass nodules in the differential diagnosis of benign and malignant nodules

目的:观察肺磨玻璃结节(GGN)的胸部CT征象,分析其在结节良恶性诊断中的价值。方法:回顾性分析2019年1月至2019年9月解放军总医院收治的65例具有GGN的CT影像征象的患者,根据病理结果分为良性组(26例)、恶性组(39例),收集整理相关临床及影像资料,分析良、恶性GGN不同CT影像特点及诊断价值。结果:良、恶性肺GGN在病变直径、形状、边界、分叶征、毛刺征、空泡征、支气管充气征、血管集束征、胸膜凹陷征和密度具有差异,差异有统计学意义(P<0.05)。其中胸膜凹陷征的诊断灵敏度和特异度最高,分别为76.92%和73.08%;而粗糙边界的诊断灵敏度和特异度最低,分别为25.64%和26.92%。分叶征、胸膜凹陷征的AUC值分别为0.718、0.75,对恶性GGN有较高的预测价值。结论:肺GGN的胸部CT征象(病变直径、形状、边界、分叶征、毛刺征、空泡征、支气管充气征、血管集束征、胸膜凹陷征、密度)有助于鉴别诊断良、恶性肺GGN。

Objective:To observe the chest CT signs features in patients with ground-glass nodule(GGN)and analyze the value of CT signs in differential diagnosis of benign and malignant lung GGN.Methods:The clinical data of 65 patients with lung GGN from January 2019 to September 2019 were retrospectively analyzed.According to the pathological results,they were divided into benign group(26 cases)and malignant group(39 cases).The differences in chest CT signs features between benign and malignant lung GGN,and the differential diagnosis value of CT figns were analyzed.Results:There were significant differences between benign and malignant lung GGN in leision diameter,shape,boundary,lobulated sign,spiculation sign,bronchus encapsulated air sign,air bronchogram,vessel convergence sign,pleural indentation and density(P<0.05).The diagnostic sensitivity and specificity of pleural indentation were highest as 76.92%and 73.08%respectively,while the diagnostic sensitivity and specificity of rough boundary were lowest as 25.64%and 26.92%respectively.The AUC values of the lobulated sign and pleural indentation were 0.718 and 0.75 respectively,which had higher predictive value for malignant GGN.Conclusion:There are some differences in chest CT signs between benign and malignant lung GGN.Leision diameter,boundary,lobulated sign,spiculation sign,vessel convergence sign,pleural indentation and density can help to distinguish benign and malignant lung GGN with diverse prosperties.