肺炎性假瘤与周围型肺癌的胸内淋巴结MSCT比较

Comparative Study of Intrathoracic Lymph Node with MSCT in Pulmonary Inflammatory Pseudotumor and Peripheral Lung Cancer

目的探讨肺炎性假瘤(PIP)与周围型肺癌(PLC)患者胸内淋巴结的多层计算机断层扫描(MSCT)形态学表现及分布特征,提高对两类疾病的鉴别诊断能力。方法回顾性纳入南京鼓楼医院及其高淳分院2017年1月至2022年3月经病理学证实为PI P、PLC患者各56例,共评估24个连续变量参数及2个分类变量。比较两组淋巴结的影像学表现差异。采用组内相关系数(ICC)及Kappa检验评价2名医师测量数据的一致性。结果两组病人在下气管旁淋巴结识别枚数、最太淋巴结长径及短径,主肺动脉窗最大淋巴结比值,主动脉弓旁淋巴结识别枚数、最大淋巴结长径及短径具有统计学意义(P<0.05),PLC患者下气管旁淋巴结上述参数及主肺动脉窗最大淋巴结比值高于PIP患者,而主动脉弓旁淋巴结上述参数则低于FIP。此外PLC较PIP更易出现肿大淋巴结,且密度多不均匀(P<0.05)。2名医师在测量淋巴结相关数据的一致性均为良好或优秀(ICC与Kappa值范围为0.635~0.819)。结论PIP及PLC胸内淋巴结在MSCT上的表现存在差异性,对临床具有指导价值。

Objective To investigate the morphological features and distribution characteristics with multislice computed tomography(MSCT)of intrathoracic lymph nodes in patients between pulmonary inflammatory pseudotumor(PIP)and peripheral lung cancer(PLC),in order to improve the ability to differentiate between the two diseases.Methods A total of 56 patients with PIP or PLC confirmed by histopathology in Nanjing Drum Tower Hospital and Gaochun People's Hospital from January 2017 to March 2022 were retrospectively included.A total of 24 continuous variable parameters and 2 categorical variable parameters were evaluated.The imaging findings of lymph nodes between the two groups were compared.Intraclass correlation coefficient(ICC)and kappa test were used to evaluate the consistency of data by two radiologists.Results The number of lymph nodes identified in the lower tracheal,the long diameter and short diameter of the maximum lymph nodes,the maximum lymph node ratio in the main pulmonary window,the number of lymph nodes identified in the pararch of aortic artery,the long diameter and short diameter of the maximum lymph nodes were statistically significant(P<0.05).In PLC patients,the above parameters of the lower tracheal lymph nodes and the maximum lymph node ratio in the main pulmonary window were higher than those of the patients with PIP,while the above parameters of the parararch lymph nodes were lower than those of the patients with PIP.The consistency of PIP related data measured by two radiologists was good or excellent(ICC and Kappa ranged from 0.635~0.819).Conclusion The intrathoracic lymph nodes of PIP and PLC have certain differences in MSCT,which provides clinical guidance.