直径<3cm非贴壁型与贴壁型肺腺癌患者HRCT影像学特征分析

HRCT Imaging Features of Non-Adherent and Adherent Lung Adenocarcinoma with the Diameter Less than 3cm in Patients

目的分析直径<3cm非贴壁型与贴壁型肺腺癌患者高分辨CT(HRCT)影像学特征。方法选取本院2017年2月至2019年7月收治且经穿刺活检或手术确诊的151例肺腺癌患者作为研究对象,分析肿瘤大小、结节类型、形态及肺结节边缘等CT征象。结果贴壁型肺腺癌以磨玻璃结节为主,实性结节、“分叶”征、“毛刺”征、异常“血管”征、空气“支气管”征及胸膜“凹陷”征均较少见;而非贴壁型肺腺癌上述CT征象则刚好相反,结节类型、“分叶”征、“毛刺”征、异常“血管”征、空气“支气管”征及.胸膜“凹陷”征在两者间的差异有统计学意义(P<005),且非贴壁.型肺腺癌平均最大直径明显大于贴壁型肺腺癌(P<005)。结论HRCT可有效显示非贴壁型与贴壁型肺腺癌的影像学特征,发现磨玻璃结节,且不伴有“分叶”征、“毛刺”征、异常“血管”征、空气“支气”管征及胸膜“凹陷”征,肿瘤直径小时,提示贴壁型肺腺癌可能性较大,患者预后较好。

Objective To analyze the high-resolution CT(HRCT) imaging features of non-adherent and adherent lung adenocarcinoma with the diameter less than 3 cm in patients. Methods 151 patients with lung adenocarcinoma diagnosed in our hospital from February 2017 to July 2019 and confirmed by puncture biopsy or surgery were selected as the research subjects, and CT signs such as size of tumor, type of nodule, shape, and edge of lung nodule were analyzed. Results Adherent lung adenocarcinomas are mainly ground-glass nodules. solid nodules, lobulation signs, burr signs, abnormal vascular signs, air bronchus signs, and pleural depression signs were all rare. The above CT signs of non-adherent lung adenocarcinoma were just the opposite. There were statistically significant differences in nodule type, lobulation sign, burr sign, abnormal vascular sign, air broncho sign and pleural depression sign between them(P<0.05). The average maximum diameter of non-adherent lung adenocarcinoma was significantly larger than that of adherent lung adenocarcinoma(P<0.05). Conclusion HRCT can effectively display the imaging characteristics of non-adherent and adherent lung adenocarcinomas. Ground-glass nodules were found without lobular signs, glitch signs, abnormal blood vessel signs, air bronchus signs, and pleural depression. When the tumor diameter is small, it suggests that adherent lung adenocarcinoma is more likely and the prognosis is better.