论著-头颈部
肺结节大小和密度测量在AIS精准判断中的价值
作者:孙姗姗1 李惠民2 陆建平1
所属单位:1.上海长海医院(上海 200433) 2.上海交通大学医学院附属新华医院放射科(上海 200092)
PDF摘要
目的探讨肺结节大小和密度测 量方法学的差异及其在肺原位腺癌(lung adenocarcinoma in situ, AIS)精准判 断中的价值,主要分析病灶的大小和密 度。方法 将97例手术病理为肺AIS的患 者纳入本研究(其中3例为两灶),女性63 例,男性34例,平均年龄(50.3±12.0) 岁。结果 纯磨玻璃结节81灶(81.0%, 81/100);混合磨玻璃结节19灶,表现为 pGGN的肺AIS,其最大径与平均径均小于 表现为mGGN的肺AIS。密度均匀pGGN的平 均CT值是(-637.2±101.5)HU;密度不 均匀pGGN的平均CT值是(-566.7±99.8) HU,其中代表性区域平均CT值是 (-438.6±117.2)HU。81个pGGN的平均CT 值是(-599.7±106.1)HU。结论 肺AIS的 判断主要依据是病灶的大小和密度。同 为肺AIS,表现为pGGN的要小于表现为 mGGN。密度测量主要针对磨玻璃成分,表 现为较均匀磨玻璃密度的AIS其密度值更 低,表现为不均匀磨玻璃密度的AIS其平 均密度高于前者,其中较高密度部分为区 分是否有侵袭性成分提供基础。
Objective To explore the methodological difference in lung nodule size and density measurement and its value in accurate diagnosis of lung adenocarcinoma in situ. Methods 97 patients 63 females, 34 males, age ranged from 24 to 79yrs, mean (50.3±12.0) yrs, with lung adenocarcinoma in situ lesions confirmed by operation pathology were included in this study. All the cases were performed ultra-high-resolution computed tomography before operation. Results 100 cases of lung AIS, including 81 pure groundglass nodules and 19 mixed ground-glass nodules. The maximum and average diameter of pGGNs were smaller than mGGN in lung AIS. In mGGN, the maximal diameter of solid component was (4.2±1.4)mm, the average diameter of solid component was (3.7±1.2)mm. The average CT value of homogeneous pGGNs were (-637.2±101.5) HU, inhomogeneous pGGNs were (-566.7±99.8)HU, the average CT value of the representative region in it is (-438.6±117.2)HU. The average CT value of the 81 pGGN was (-599.7±106.1)HU. Conclusion The lesions of lung AIS were judged mainly by the size and density of the lesion. The pGGNs were smaller than mGGNs in lung AIS. The average CT value in homogeneous AIS lesions were lower than inhomogeneous lesions, the higher density section provides the basis for distinguishing aggressive components.
【关键词】肺原位腺癌;磨玻璃结节;超高分辨率CT
【中图分类号】R322.3+5
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.09.001
前言
随着肺癌筛查的普及,越来越多的磨玻璃结节被发现,其定性诊 断也成为热点与难点之一。在鉴别肺GGN的良恶性及浸润程度方面的已 有一些研究,多侧重于CT形态学征象的分析,目前,通过测量病灶直 径和密度来评估结节是较常用的方法,对鉴别结节的良恶性有一定帮 助。
中国CT和MRI杂志
第16卷, 第 9 期
2018年09月
相关文章