摘要
目的研究肺内磨玻璃结节(ground-glass opacity,GGN)与微小血管的关系及类型,探讨多层螺旋CT(MSCT)对其诊断价值。方法回顾性分析经病理或临床证实的45例GGN的CT图像。将GGN与微小血管的关系分为5型:Ⅰ型,血管从旁绕行未进入GGN内部;Ⅱ型血管走行于病灶内,无增粗、扭曲、僵直及分出微小血管;Ⅲ型,单支血管伸入病灶,且病灶内血管增粗、扭曲及僵直;Ⅳ型,一支血管进入病灶且发出微小血管;Ⅴ型,2支或以上血管进入病灶形成的微小血管,且相与联通。对GGN的病理类型进行统计学分析。结果 45例GGN炎症2例;非典型腺瘤样增生4例;原位腺癌7例;微浸润腺癌11例;浸润性腺癌21例。45例GGN与微小血管的关系5种类型(Ⅰ-Ⅴ)分别为3、3、12、11、16例,其中Ⅴ型最多。16例Ⅴ型的均为浸润性腺癌;11例Ⅳ型中浸润性腺癌8例。Ⅳ型+Ⅴ型为浸润性腺癌的可能性较大。三组GGN病理(炎症组、浸润前病变组、浸润性腺癌组)与微血管关系比较有统计学意义(P<0.001)。结论不同病理类型的GGN与微小血管的关系不同,对GGN的性质判定有一定帮助。
Objective To investigate the relationships and types between pulmonary ground glass nodules(GGNs)and microvessel,and explore its value in diagnosis.Methods To study retrospectively the MSCT images of 45 cases proved by operation,pathology or clinical materials.The relationships between GGN and microvessel were divided into five types.Type I:The vessel were circumvent GGN lesions.Type lI:the ovessel were normal course in the GGO.TypeⅢ:The ovessel was distortion and extension in the GGN.TypeⅣ:the vessel reached into and gived off branches in the GGO.TypeⅤ:2 or more than 2 ovessels gived off branches and communicated with each other in the GGNs.The relationship type and pathologic of GGN were statistically analyzed.Results Of 45 GGNs,2 were inflammation,4 were atypical adenomatous hyperplasia(AAH),7 were adenocarcinoma in situ(AIS),11 were mininally invasive adenocarcinoma(MIS),21 were invasive adenocarcinoma(IAC).TypesⅠ-Ⅴmicrovessel relationships were observe in 3,3,12,11 and 16 GGNs.TypeⅤrelationship was obvious one.All 16 cases of typeⅤwere IAC.There were 8 IAC,when the relationship between GGNs and microvessel.There was significant association between IAC and typeⅣandⅤof GGNs,according to statistical analysis.Statistical significance were found between 3 groups of pathology result(inflammation group,precancerosis ground,IAC ground)and microvessel(P<0.001).Conclusion There were different relationships between GGNs and microvessel.It is helpful for differential diagnosis by analyzing the relationships between GGNs and microvessel.
作者
毛伍兵
李水连
张英俊
MAO Wu-bing;LI Shui-lian;ZHANG Ying-jun(Department of CT Room,Hospital of Traditional Chinese Medicine of Zhongshan,Zhongshan 528400,Guangdong Province,China)
出处
《中国CT和MRI杂志》
2018年第4期66-69,共4页
Chinese Journal of CT and MRI
基金
广东中山市医学科研基金资助项目(2017A020103)
