肺磨玻璃结节胸部CT靶扫描非常规扫描图像诊断与病理对照

Chest CT target scan unconventional scan image diagnosis and pathological control

目的:探讨肺磨玻璃结节胸部CT靶扫描非常规扫描图像诊断及其病理的关系。方法:回归性分析2020年12月—2023年6月于宁海县第一医院放射科行胸部CT靶扫描的190例肺磨玻璃结节患者的临床资料。将病理结果分为四种:浸润性腺癌、微浸润腺癌、浸润前病变和炎性肉芽肿,各有92例、55例、33例和10例,其中33例浸润前病变中有不典型腺瘤样增生10例和原位腺癌23例。对四组患者病灶的分叶、毛刺、支气管充气、空泡以及胸膜凹陷这些形态特征进行对比分析。结果:浸润性腺癌与浸润前病变在分叶、毛刺和胸膜凹陷这些特征方面,差异具有统计学意义(P<0.05);浸润性腺癌与微浸润腺癌在胸膜凹陷征有显著差异(P<0.05);微浸润腺癌与浸润前病变在毛刺和胸膜凹陷征有显著差异(P<0.05);浸润组结节一般比微浸润组边缘多毛刺、内部空泡、胸膜凹陷以及分叶(P<0.05)。结论:肺磨玻璃结节的胸部CT靶扫描征象与其患者病理结果具有相关性,分析患者胸部CT靶扫描的图形征象有利于对患者术前肺磨玻璃结节进行鉴别诊断以及进行分期。

Objective To investigate the relationship between chest CT target scan unconventional scan image diagnosis and pathology of pulmonary calculi-like nodules.Methods Regression analysis was carried out for the clinical data of 190 patients with ground-glass nodules who underwent chest CT target scanning in the Department of Radiology of Ninghai First Hospital from December 2020 to June 2023.The pathological results were divided into four categories:Invasive gonadal carcinoma,micro-invasive adenocarcinoma,pre-infiltration lesions and inflammatory granuloma,each with 92 cases,55 cases,33 cases and 10 cases;of which 33 cases had 10 cases of atypical adenomatous hyperplasia and 23 cases of orthotopic adenocarcinoma in the pre-infiltration lesions.The morphological characteristics of lobes,burrs,bronchial inflations,vacuoles and pleural depressions were compared between the four groups.Results There were significant differences in the characteristics of laryngeal,burr and pleural depressions between infiltrating adenomas and invasive lesions(P<0.05).There was a significant difference between infiltrating adenocarcinoma and microinflammatory carcinoma(P<0.05).There was a significant difference between the micro-infiltrating adenocarcinoma and the pre-infiltration lesion in the burr and pleural depression(P<0.05).The infiltration group was generally marginally glabrous than the micro-infiltration group,with internal vacuoles,pleural depressions and lobes(P<0.05).Conclusions The chest CT target scan signs of pulmonary ground glass nodules are correlated with their pathological results,and the analysis of the chest CT target scan is conducive to the differential diagnosis and staging of pulmonary ground glass nodules before surgery.