微浸润型肺腺癌的CT分型及其临床意义
Explore CT classification and clinical significance for minimal lung adenocarcinoma
张磊 1谢超 1谢晓东 1沈文荣1
作者信息
- 1. 江苏省肿瘤医院CT/MRI室 江苏省肿瘤防治研究所南京医科大学附属肿瘤医院,江苏 南京 210009
- 折叠
摘要
目的 探讨微浸润型肺腺癌(MIA)的CT分型及其临床意义,以提高对此类肺腺癌的认识.方法 回顾性分析本院经手术病理组织学证实为 MIA 51 例患者共 51 个病灶,分析其临床及不同CT表现,并对其不同CT表现进行分类.结果 51 例患者,按CT表现将51 个病灶分为 3 型:纯磨玻璃结节(pGGN)型 34 个,混合型磨玻璃结节(mGGN)型 8 个,部分实性磨玻璃结节(Part-solid GGN)型 9 个.pGGN最长直径范围约 0.62~2.41 cm(1.01 cm±0.36 cm),整体密度较均匀,CT 值增加值范围约 150~512 HU (266 HU±81 HU);mGGN表现为在磨玻璃结节(GGN)阴影内见散在点状或圆形、椭圆形密度增高影,但纵隔窗未见明确软组织成分;Part-solid GGN示纵隔窗显示的实性成分最长直径范围约0.02~0.49 cm(0.2 cm±0.16 cm).形态学特征方面,虽然 3 种结节类型在形状、边缘、支气管像、胸膜牵拉、血管扩张显示方面差异无统计学意义,但Part-solid GGN 与 mGGN 在分叶、毛刺及胸膜牵拉出现率高于 pGGN,且 MIA分叶中有 50%表现为深分叶,深分叶在 pGGN 与 mGGN/Part-solid GGN 间差异有统计学意义.结论 MIA有多种CT表现,对于Part-solid GGN及mGGN,病灶的实性成分形态及其大小对于诊断MIA有重要作用;对于pGGN诊断MIA需紧密结合病灶的大小及病灶的CT值综合考虑.
Abstract
Objective To focus on CT classification and clinical significance for minimal lung adenocarcinoma(MIA),to improve the knowledge of this kind of lung adenocarcinoma.Methods 51 cases of MIA confirmed by histopathology were retrospectively evaluated in our hospital,which were analyzed and classified by CT manifestation.Results Of the 51 patients,according to CT features ,lesions were divided into three types:pure ground-glass nodule (pGGN)(34 cases),mixed ground-glass nodule(mGGN)(8 cases),Part-solid GGN (9 cases).The maximum diameter of pGGN ranged from 0.62-2.41 cm (1.01 cm±0.36 cm),the overall density was uniform and the CT value-plus ranged from 150-512 HU (266 HU±81 HU).mGGN showed scattered punctate or rounded,oval shaped high density in GGN in lung window,which was not visible in mediastinal window.Part-solid GGN showed solid component in both lung window and mediastinal window and the longest average diameter of the solid component ranged from 0.02-0.49 cm(0.2 cm±0.16 cm).While no statistical differences were found between the three types in shape,margin,air bronchogram,pleural retraction,vessel dilatation, but lobular,burr and pleural retraction were observed more frequently in Part-solid GGN and mGGN than that in pGGN.In addition, 50% of lobulation were deep lobulation,which was showed statistical difference between pGGN and mGGN/Part-solid GGN groups. Conclusion MIA has multiple CT manifestations,the morphology and size of solid component plays an important role in the diagnosis of MIA. For pGGN,lesion size and CT value-plus should be considered when diagnosing MIA.
关键词
微浸润型肺腺癌/计算机体层成像Key words
minimal lung adenocarcinoma/computed tomography引用本文复制引用
基金项目
江苏省卫生和计划生育委员会科学研究项目(H201509)
出版年
2018
NETL
NSTL
维普
万方数据