Lung-RADS分级系统联合CT征象在孤立性肺磨玻璃影结节诊断中的应用

Application of Lung-RADS grading system combined with CT signs in diagnosis of solitary pulmonic ground glass nodules

目的探讨肺部影像报告和数据系统(Lung-RADS)分级联合CT征象在孤立性肺磨玻璃影结节(GGN)诊断中的应用价值。方法收集2018年5月至2019年5月在郑州人民医院检查的孤立性肺GGN患者90例,按照GGN病理检查或两年随访结果分为良性组34例和恶性组56例。统计其Lung-RADS分级和CT影像学表现特征;Logistic回归分析GGN良恶性的相关因素;构建Lung-RADS和CT征象的联合变量;受试者工作特征(ROC)曲线分析其诊断性能。结果Lung-RADS分级诊断GGN性质的敏感度为89.29%,特异度为58.82%;恶性组不规则形态、毛刺征、分叶征、胸膜牵拉征、空泡征、空气支气管征的比例及Lung-RADS分级均显著高于良性组(P<0.05);多因素回归分析毛刺征、分叶征、Lung-RADS分级是恶性GGN的独立相关因素(P<0.05);Lung-RADS分级与CT征象的联合变量诊断GGN的曲线下面积(AUC)为0.887,灵敏度及特异度分别为94.12%和83.33%,高于Lung-RADS分级诊断性能。结论Lung-RADS分级联合CT征象在鉴别GGN性质具有一定的诊断价值。

【Objective】To investigate the application value of Lung Imaging Reporting and Data System(Lung-RADS)classification combined with CT signs in the diagnosis of lung solitary ground glass nodule(GGN).【Methods】A total of 90 patients with lung solitary GGN who were examined in Zhengzhou People's Hospital from May 2018 to May 2019 were collected and divided into the benign group(34 cases)and malignant group(56 cases)according to GGN pathological examination or 2-year follow-up results.The lung-RADS grade and CT imaging features were analyzed,Logistic regression was used to analyze the related factors of benign and malignant GGN,the combined variables of Lung-RADS and CT signs were constructed and its diagnostic performance of GGN was analyzed by ROC curve.【Results】The sensitivity and specificity of Lung-RADS grading for the diagnosis of GGN were 89.29%and 58.82%,respectively.The proportions of irregular morphology,burr sign,lobulation sign,pleural traction sign,vacuole sign,air bronchial sign and Lung-RADS grade in malignant group were significantly higher than those in benign group(P<0.05).Multi-factor regression analysis showed that burr sign,lobulation sign and Lung-RADS grade were independent related factors of malignant GGN(P<0.05).The AUC of the combination variable of Lung-RADS grade and CT signs in the diagnosis of GGN was 0.887,the sensitivity and specificity were 94.12%and 83.33%,respectively,which were higher than the diagnostic performance of Lung-RADS grade.【Conclusion】Lung-RADS grade combined with CT signs has certain diagnostic value in differentiating GGN properties.