HRCT features distinguishing pre-invasive from invasive pulmonary adenocarcinomas appearing as ground-glass nodules
HRCT features distinguishing pre-invasive from invasive pulmonary adenocarcinomas appearing as ground-glass nodules
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DOI：
10.1007/s00330-015-4131-3
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发表时间：
2016-09-01
影响因子：
5.9
通讯作者：
Zhao, Rui Ying
中科院分区：
文献类型：
--
作者：
Zhang, Yu;Shen, Yan;Zhao, Rui Ying
研究区分肺原位腺癌（AIS）和微创腺癌（MIA）与表现为磨玻璃结节（GGN）的浸润性腺癌（IAC）的高分辨率计算机断层扫描（HRCT）特征，229例患者的237个小于2 cm的GGN回顾性分析经手术病理证实的139个AIS-MIA结节和98个IAC结节。分析并比较AIS-MIA和IAC的HRCT表现。两组病例在密度、结节直径、实性成分直径、磨玻璃样和实性成分CT值、分叶状、毛刺样边缘、肺静脉和肺动脉异常、支气管充气征、胸膜凹陷征等方面差异有统计学意义。多因素分析和ROC分析显示，直径较大的结节（口径12.2毫米）和固体部件（aeyen6.7mm），实性成分CT值较高（aeyen-192 HU）与IACs之间有显著相关性，HRCT可鉴别AIS-MIA与IACs的形态学特征，结果表明：1例呈GGN样的IACs，其直径一般为12.2mm，实性成分直径一般为6.7mm; 2例呈GGN样的IACs，其实性成分直径一般为6.7mm，IACs常表现为-192HU，欧洲IACs较AIS-MIA多见支气管充气征。
To investigate the high-resolution computed tomography (HRCT) features that distinguish lung adenocarcinomas in situ (AISs) and minimally invasive adenocarcinomas (MIAs) from invasive adenocarcinomas (IACs) appearing as ground-glass nodules (GGNs), and to select candidates for sublobar resection.Two hundred and twenty-nine patients with 237 GGNs of less than 2 cm (139 AIS-MIA nodules and 98 IAC nodules) confirmed by surgery and pathology were retrospectively reviewed. The HRCT features of the AIS-MIAs and IACs were analysed and compared. Receiver operating characteristic (ROC) analyses were conducted to determine the cutoff values for the qualitative variables and their diagnostic performances.Significant differences were found in the density, nodule and solid component diameters, CT values of the ground-glass and solid components, lobulated shape, spiculated margin, abnormal pulmonary vein and artery, air bronchogram, and pleural indentation of the GGNs between the two groups. Multivariate and ROC analyses revealed that larger diameter of nodules (aeyen12.2 mm) and solid components (aeyen6.7 mm), and higher CT values of the solid components (aeyen -192 HU) in the GGNs with air bronchogram were significantly associated with IACs.HRCT can identify distinguishing morphological features between AIS-MIAs and IACs, and is helpful for selecting candidates for sublobar resection.aEuro cent IACs appearing as GGNs were often aeyen 12.2 mm in diameter.aEuro cent IACs were often aeyen 6.7 mm in solid component diameter.aEuro cent The solid components of the IACs often exhibited aeyen -192 HU.aEuro cent IACs exhibited air bronchogram more frequently than AIS-MIAs.