多排螺旋CT对浸润性肺腺癌与浸润前病变的CT鉴别诊断

Multi Slice Spiral CT in Differential Diagnosis of Invasive Lung Cancer and Preinvasive Lesions

目的分析多排螺旋CT对浸润性肺腺癌与浸润前病变的CT鉴别诊断。方法整群收集该院2011年5月—2014年3月期间诊治的135例浸润性肺腺癌和浸润前病变患者作为研究对象,所有患者均经手术病理证实,且所有患者在开展手术之前均实施多排螺旋CT扫描。结果病灶形态包:有76个表现为不规则形,另外59个表现为圆形类圆形;本组患者的病灶边缘情况为:有89个为分叶,另外46个为毛刺;患者的病灶内部结构:有38个为空泡征,有35个为支气管征;邻近结构:有49个为血管集束,65个为胸膜凹陷,另外21个为血管增粗。浸润性腺癌与浸润前病变在CT征象以及病灶直径方面通过χ2检验差异有统计学意义(P<0.05)。同时,浸润前病变和浸润性肺腺癌的实性部分比较差异有统计学意义(P<0.05),浸润前病变在纯磨玻璃结节中大约占据了66.78%,混合性密度磨玻璃结节在浸润性腺癌中的比例为91.67%,病灶直径最小为浸润前,最大为浸润性腺癌,并呈现递增的势态发展。结论多排螺旋CT能够比较准确的诊断和鉴别诊断浸润性肺腺癌与浸润前病变。

Objective To analyze the value of multi-slice spiral CT in differential diagnosis of invasive lung cancer and preinvasive lesions. Methods Selected 135 patients with invasive lung cancer or preinvasive lesions in our hospital from 2011 May to March 2014 as research objects, and all the patients were confirmed by operation and pathology. All the patients accepted multi row spiral CT scanning before operation. Results About the lesions form, there were 76 characterized by irregular, while 59 performance for round; For patients of this group, when refer to edge of lesions, there are 89 for leaf, and 46 for burr; The internal structure of lesions: 38 were cavitation and 35 were bronchus; Adjacent structure: 49 for vascular cluster, have 65 for pleural indentation, while 21 for vascular enlargement. By chi-square, there were statistical differences between preinvasive lesions and invasive lung cancer on CT signs and lesions diameter(P<0.05).There were statistical differences between the solid part of preinvasive lesions and invasive lung cancer(P<0.05). Preinvasive lesions in pure ground glass nodules accounted for approximately 66.78%,mixed density of ground glass nodules in invasive adenocarcinoma in the proportion of more than ninety percent. The smallest diameter of preinvasive lesions, the largest for invasive adenocarcinoma, and presents the developments of increasing. Conclusion Multi slice spiral CT can accurately diagnose and differentially diagnose invasive lung cancer and preinvasive lesions.