磨玻璃密度肺癌与炎症的HRCT鉴别诊断

发布时间：2018-06-23 11:44

本文选题：磨玻璃密度影 + 细支气管肺泡癌　；参考：《中华肿瘤防治杂志》2015年09期

【摘要】：目的回顾性分析表现为磨玻璃密度结节(ground-glass nodules,GGNs)的肺部炎症与肺癌的高分辨率CT(high-resolution HRCT)表现,以期获得对两者有鉴别诊断意义的CT征象。方法对2010-08-01-2013-11-30山东省肿瘤医院经病理或临床确诊的80例GGNs的HRCT形态学表现进行回顾性分析,并对其影像学征象进行统计学分析。结果 80例GGNs患者中,肺部炎症21例(9个pGGNs和12个mGGNs),肺癌59例(14个pGGNs和45个mGGNs),其中原位腺癌9例,微浸润腺癌12例,腺癌35例,腺鳞癌3例。统计学分析显示,80例GGNs患者中,肺炎性病变与肺癌患者发病年龄(P=0.139)、性别比(P=0.602)、病灶大小(P=0.593)及位置(P=0.626)的差异均无统计学意义。21个肺部炎症中9个pGGO,12个mGGO。59个肺癌中14个pGGNs,45个mGGNs。统计学分析显示,肺部炎症及肺癌之间,病灶的形状、清晰光滑的边界、空泡/空腔及正常支气管充气征差异无统计学意义,P0.05。其他MDCT征象中,边界(模糊、清晰毛糙)、分叶、毛刺、支气管截断征、胸膜凹陷征、血管集束征及小叶间隔有无增厚差异有统计学意义,P0.05。结论分析GGNs的HRCT影像学表现,边界(模糊、清晰毛糙)、分叶、毛刺、支气管截断征、胸膜凹陷征、血管集束征及小叶间隔有无增厚有助于肺癌和肺部炎症的鉴别,动态观察其影像学变化更利于准确的诊断GGNs。
[Abstract]:Objective to retrospectively analyze the lung inflammation and high resolution CT (high-resolution) findings of ground-glass nodules-density nodules (GGNs) in order to obtain the CT signs of differential diagnosis between them. Methods the morphological features of HRCT in 80 cases of GGNs confirmed by pathology or clinic in Shandong Cancer Hospital from 2010-08-01-2013-11-30 were analyzed retrospectively and their imaging features were analyzed statistically. Results among 80 patients with GGNs, there were 21 cases of pulmonary inflammation (9 pGGNs and 12 mGGNs), 59 cases of lung cancer (14 pGGNs and 45 mGGNs), 9 cases of in situ adenocarcinoma, 12 cases of microinvasive adenocarcinoma, 35 cases of adenocarcinoma and 3 cases of adenosquamous carcinoma. Statistical analysis showed that there were no significant differences in age (P0. 139), sex ratio (P0. 602), lesion size (P0. 593) and location (P0. 626) between pneumonitis and lung cancer in 80 patients with GGNs. There were 9 pGGOs in 21 pulmonary inflammation, 14 pGGNs in 12 MGGO.59 lung cancers, 45 MGGNs. Statistical analysis showed that there was no significant difference between pulmonary inflammation and lung cancer in the shape of lesion, clear and smooth boundary, vacuole / cavity and normal bronchi inflation sign (P 0.05). In other MDCT signs, there were significant differences in boundary (fuzzy, clear and rough), lobulation, burr, bronchial truncation sign, pleural depression sign, vascular cluster sign and interlobular septal thickening (P 0.05). Conclusion Analysis of HRCT imaging findings of GGNs, margin (fuzzy, clear and rough), lobulation, burr, bronchial truncation, pleural indentation, vascular cluster sign and thickening of interlobular septum may contribute to the differential diagnosis of lung cancer and pulmonary inflammation. Dynamic observation of its imaging changes is more conducive to accurate diagnosis of GGNs.
【作者单位】：山东省医学科学院·山东省肿瘤防治研究院放射科;济南大学·山东省医科院医学与生命科学学院;
【分类号】：R734.2;R730.44

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