窗口技术对肺腺癌磨玻璃影浸润性的诊断价值

发布时间：2018-06-07 02:08

本文选题：肺肿瘤 + 腺癌　；参考：《中国医学影像学杂志》2015年06期

【摘要】：目的探讨窗宽调整对表现为磨玻璃影的肺腺癌浸润性的诊断作用,为正确诊断不同类型的肺腺癌提供指导。资料与方法回顾性分析肺窗表现为磨玻璃影且纵隔窗病灶不可见的浸润前病变102例和浸润性病变107例肺腺癌患者的术前CT资料,102例浸润前病变中,不典型腺瘤样增生25例,原位腺癌77例;107例浸润性病变中,微浸润腺癌78例,浸润性腺癌29例。固定纵隔窗窗位(40 HU),调节窗宽值至病灶不可见,比较两组不同病灶消失时的窗宽值,然后通过ROC曲线确定两组病灶消失的窗宽值的最佳截断点。结果浸润前病变与浸润性病变病灶消失的窗宽值不同(Z=-6.203,P0.05),窗宽值对于肺腺癌浸润性的诊断价值较好(ROC曲线下面积0.748,P0.05),1303 HU为浸润前病变和浸润性病变病灶消失的最佳窗宽截断点(敏感度为56.9%,特异度为86.0%)。结论窗口技术对于磨玻璃性肺腺癌浸润性的诊断有一定的指导意义,当窗宽1303 HU时,病灶消失为浸润前病变的可能性大;当窗宽1303 HU时,病灶消失为浸润性病变的可能性大。
[Abstract]:Objective to investigate the role of window width adjustment in the diagnosis of invasive lung adenocarcinoma with glass grinding, and to provide guidance for the correct diagnosis of different types of lung adenocarcinoma. Materials and methods the preoperative CT findings of 102 cases of preinvasive lesions and 107 cases of invasive lesions of lung adenocarcinoma were retrospectively analyzed, including 25 cases of atypical adenomatous hyperplasia. Among the 77 cases of in situ adenocarcinoma, 78 cases were microinvasive adenocarcinoma and 29 cases were invasive adenocarcinoma. The window width of the mediastinal window was fixed at 40 HUU, and the window width was adjusted to be invisible. The window width of the two groups was compared when the lesions disappeared, and the best truncation point of the window width of the two groups was determined by the ROC curve. Results the window width of preinvasive lesions was different from that of infiltrative lesions. The value of window width in the diagnosis of invasive lung adenocarcinoma was better. The area under ROC curve was 0.748 and P0.05HU was the best window for preinvasive lesions and the disappearance of invasive lesions. Wide truncation (sensitivity 56.9, specificity 86.0). Conclusion window technique has a certain guiding significance in the diagnosis of invasive lesions in ground-glass adenocarcinoma of the lung. When the window width is 1303 Hu, the lesion is more likely to disappear into preinvasive lesions, and when the window width is 1303 Hu, it is more likely to disappear into invasive lesions.
【作者单位】：同济大学附属上海市肺科医院影像科;
【分类号】：R734.2;R730.44

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