不同病理类型肺部磨玻璃结节的高分辨CT定量参数鉴别诊断

An Analysis of Diagnosing Pulmonary Ground Glass Nodules of Different Pathological Types Through High Quantitative Parameter of Resolution CT

目的:探讨高分辨CT(HRCT)对不同病理类型肺部磨玻璃结节(GGN)的鉴别诊断价值。方法:选取2017年12月至2019年12月本院诊治的肺部GGN患者210例为研究对象,所有患者经影像学检查及病理学检查。比较不同病理类型肺部GGN患者病灶大小、三维比率、二维比率、实性成分大小、形状、边缘毛刺、边缘分叶、空泡等差异。结果:病理学检查显示,210例患者中,肺部炎症、AAH、AIS、MIA及IAC分别有24、30、50、62、44例。影像学资料显示,肺部GGN呈毛刺、分叶、空泡征、胸膜凹陷征、病灶不规则、边界模糊者,炎症组<AAH组<AIS组<MIA组<IAC组,差异均具有统计学意义(P<0.05)。且病灶大小、实性成分大小,炎症组<AAH组<AIS组<MIA组<IAC组,差异具有统计学意义(P<0.05);三维比率、二维比率五组差异不具有统计学意义(P>0.05)。另ROC曲线显示,实性成分大小诊断MIA、IAC肺部GGN的AUC分别为1.000、0.937,准确性高,敏感度、特异度:MIA为100%、100%,IAC为88.6%、90.3%,诊断价值良好。结论:高分辨CT对不同病理类型肺部磨玻璃结节具有重要的鉴别价值,可根据HRCT影像学特征的定性及定量资料进行综合评估。

Objective:To explore the value of high resolution CT(HRCT)in the differential diagnosis of different pathological types of lung ground glass nodules(GGN).Methods:210 patients who were admitted to our hospital from Dec.2017 to Dec.2019 with lung GGN were selected as the research object,and all patients underwent imageological examination and pathological examination.Comparison was conduct among patients with different pathological types of lung GGN on differences of lesion size,3 d and 2 d ratios,solid component size,shape,edge,burr,boundry points and lobulation,cavitation.Results:Pathological examination showed that among the 210 patients,pulmonary inflammation,AAH,AIS,MIA and IAC were 24,30,50,62 and 44,respectively.Imaging data showed that the lung GGN presented burr,lobulation,cavitation sign,pleural depression sign,irregular lesion and fuzzy boundary,and the inflammatory group<AAH group<AIS group<MIA group<IAC group,with statistically significant differences(P<0.05).In addition,as to the size of lesions and the size of solid components,data showed the inflammatory group<AAH group<AIS group<MIA group<IAC group;the difference was statistically significant(P<0.05).There was no significant difference between the five groups(P>0.05).In addition,the ROC curve showed that the AUC of solid component size in diagnosing MIA and IAC lung GGN was 1.000 and 0.937,respectively,with high accuracy,sensitivity and specificity:MIA was 100%and 100%,IAC was 88.6%and 90.3%,with good diagnostic value.Conclusion:High resolution CT has important value in distinguishing pulmonary ground-glass nodules of different pathological types,and can be comprehensively evaluated according to qualitative and quantitative data of HRCT imaging characteristics.