含实性成分的可吸收肺磨玻璃结节HRCT征象分析

Analysis of HRCT features of absorbable ground glass nodules with solid components

目的通过对肺部含有实性成分磨玻璃结节的影像分析,探讨可吸收性含实性成分磨玻璃结节的HRCT影像征象及其价值。方法选取59例含实性成分磨玻璃结节灶。病例分为两组,其中抗炎和/或抗感染后吸收消失的25例为可吸收组,直接手术切除且病理为肺腺癌的34例为对照组,对两组在病变外形、病变边界、支气管形态、病变边缘特征、有无分叶征、有无空泡征、有无血管扭曲、有无胸膜凹陷征、周围改变、实性成分形态等影像征象做分析对比,利用单因素及多因素Logistics回归进行统计分析处理。结果两组在病变外形、病变边界、支气管形态、病变边缘特征、有无分叶征、有无空泡征、有无血管扭曲、有无胸膜凹陷征、周围改变、实性成分形态等的征象差异均有统计学意义,且与可吸收组有关,多因素Logistics回归显示可吸收性含实性成分磨玻璃结节的独立征象因素为实性成分形态规整且边界清楚、无空泡征、无血管扭曲、无胸膜凹陷征,其ROC曲线下面积为0.945,特异度为0.848,灵敏度为0.920。结论对HRCT征象表现为实性成分形态规整且边界清楚、无空泡征、无血管扭曲、无胸膜凹陷征的含实性成分磨玻璃结节,尤其是实性成分规整呈类圆形者,应给予抗感染或/和抗炎治疗。

Objective To explore the HRCT imaging features and value of absorbable ground glass nodules with solid components by analyzing the images of pulmonary ground glass nodules with solid components.Methods 59 cases of ground glass nodules with solid components were analyzed retrospectively.The cases were divided into two groups,in which 25 cases of absorption disappeared after anti-inflammatory and/or anti infection were absorbable group,and 34 cases with lung adenocarcinoma after direct surgical resection were regarded as control group.Statistical analysis was performed by univariate and multivariate logistic regression.Results There were significant differences between the two groups in terms of the appearance of lesions,lesion boundary,bronchial morphology,lesion edge characteristics,lobulation sign,vacuole sign,vascular distortion,pleural indentation sign,peripheral changes,solid component morphology,and other signs between the two groups,and were related to the absorbable group.Multivariate logistic regression showed the independent signs of absorbable ground glass nodules with regular solid components and well-defined solid components,no vacuole sign,no vascular distortion and no pleural indentation.The area under ROC curve was 0.945,the specificity was 0.848,and the sensitivity was 0.920.Conclusion Anti infective or/and anti-inflammatory treatment should be given to the ground glass nodules with solid components with regular shape and clear boundary,no vacuoles,no vascular distortion and no pleural indentation on HRCT.