高分辨率CT对不同时期肺部纯磨玻璃结节侵袭性的临床预测价值

Clinical Value of High-resolution CT in Predicting the Invasiveness of Pulmonary Pure Ground Glass Nodules in Different Stages

目的:探析高分辨率电子计算机断层扫描(HRCT)对不同时期肺部纯磨玻璃结节(pGGN)侵袭性的临床预测价值。方法:选择2018年1月—2021年10月三明市第二医院收治的76例pGGN患者,根据病理学检查结果将患者分为A组(浸润前病变)、B组(微浸润病变)、C组(浸润性病变),并对所有患者均进行HRCT检查。比较三组HRCT检查所得结果中的影像学征象,并分析微浸润病变与浸润性病变直径最佳阈值与诊断敏感度、特异度。结果:根据HRCT检查结果显示,三组病变部位及毛刺、胸膜凹陷等征象发生率差异均无统计学意义(P>0.05),而三组分叶、空泡、血管改变、空气支气管、瘤肺界面等征象发生率差异均有统计学意义(P<0.05),C组病灶直径大于A组与B组(P<0.05),B组与A组患者病灶直径差异无统计学意义(P>0.05);微浸润病变与浸润性病变ROC曲线分析,病变直径最佳阈值为13.9 mm,诊断敏感度为80.23%,特异度为81.84%。结论:HRCT检查能够获取不同时期pGGN患者病灶大小、分叶等各种征象,从而为临床评估其侵袭性提供可靠依据。

Objective:To explore the clinical predictive value of high-resolution computed tomography(HRCT)in the invasiveness of pulmonary pure ground glass nodules(pGGN)in different periods.Method:A total of 76 patients with pGGN treated in Sanming Second Hospital from January 2018 to October 2021 were selected.According to the pathological examination results,the patients were divided into group A(pre invasive lesions),group B(micro invasive lesions)and group C(invasive lesions).All patients were examined by HRCT.The imaging signs in the HRCT results of the three groups were compared,and the optimal threshold of lesion diameter,diagnostic sensitivity and specificity in micro invasive lesions and invasive lesions were analyzed. Result: According to the results of HRCT examination, there were no significant differences in the incidences of lesions, burr and pleural depression among the three groups (P>0.05), but there were differences in the incidences of lobules, vacuoles, vascular changes, air bronchus and tumor lung interface among the three groups (P<0.05). The diameter of lesions in group C was larger than those in group A and group B (P<0.05), and there was little difference in the diameter of lesions between group B and group A (P>0.05). According to the ROC curve analysis of micro invasive lesions and invasive lesions, the optimal threshold of lesion diameter was 13.9 mm, the diagnostic sensitivity was 80.23%, and the specificity was 81.84%. Conclusion: HRCT can obtain various signs such as lesion size and lobulation in patients with pGGN at different stages, so as to provide a reliable basis for clinical evaluation of its invasiveness.