摘要
目的探讨亚厘米肺结节微小浸润型肺癌的高分辨率CT(HRCT)表现及HRCT诊断亚厘米肺结节微小浸润型肺癌的临床价值。方法选择2019年6月至2021年6月梅州市中医医院32例手术病理证实为微小浸润型肺癌的亚厘米肺结节患者为研究对象,全部患者术前均使用佳能320排640层谱黄金CT行肺HRCT检查,回顾性分析患者的影像学资料及诊断结果,观察亚厘米肺结节微小浸润型肺癌的HRCT表现,以术后病理诊断结果为金标准,评价HRCT诊断亚厘米肺结节微小浸润型肺癌的准确率。结果32例患者HRCT共计检出亚厘米肺微小结节33枚,结节检出率为100%。32例患者HRCT诊断微小浸润型肺癌31例、浸润性肺癌1例,基于手术病理金标准,HRCT诊断微小浸润型肺癌准确率为96.77%。HRCT表现:结节最大径0.3~0.8 cm不等,平均0.73 cm;规则圆形或类圆形25枚,占75.76%;Ⅱ类mGGN 17枚,Ⅲ类mGGN 9枚,合计占78.79%;84.85%无分叶征,93.94%无毛刺征,78.79%无空泡,69.70%无空气支气管征,73.76%无胸膜凹陷;微血管征象以Ⅱ型、Ⅲ型居多,占78.79%。结论HRCT可以有效检出亚厘米肺结节,结节形态、密度、血管征象以及分叶、毛刺、空泡、胸膜凹陷等结构征象可以为HRCT定性诊断微小浸润型肺癌提供有价值的影像学依据和参考,诊断准确率高。
Objective To investigate the high-resolution CT(HRCT)performance of micro-invasive lung cancer with sub-centimeter pulmonary nodules and the clinical value of HRCT in diagnosing micro-invasive lung cancer with sub-centimeter pulmonary nodules.Methods A total of 32 patients with micro-invasive lung cancer with sub-centimeter pulmonary nodules confirmed by surgical pathology in Meizhou Hospital of Traditional Chinese Medicine from June 2019 to June 2021 were selected as study subjects.All patients underwent lung HRCT with Canon 320-row 640-layer spectral gold CT before surgery,the imaging data of patients and diagnostic results were retrospectively analyzed,and the HRCT performance of micro-invasive lung cancer with sub-centimeter pulmonary nodules was observed.The accuracy of HRCT in diagnosing micro-invasive lung cancer with sub-centimeter pulmonary nodules was evaluated by using the postoperative pathological diagnosis results as the gold standard.Results A total of 33 sub-centimeter pulmonary nodules were detected by HRCT in 32 patients,with the detection rate of 100%.31 cases of micro-invasive lung cancer and 1 case of invasive lung cancer were diagnosed by HRCT in 32 patients,with the accuracy rate of 96.77%based on the gold standard of surgical pathology.As for the HRCT performance,the mean diameter of nodules ranged from 0.3 to 0.8 cm,with an average of 0.73 cm.There were 25 regular round or round-like nodules,accounting for 75.76%.17 typeⅡmixed ground-glass nodules(mGGN)and 9 typeⅢmGGN were detected,with the two types accounting for 78.79%in total.84.85%of nodules had no lobulated sign,93.94%had no burr sign,78.79%had no vacuole,69.70%had no air bronchial sign,and 73.76%had no pleural depression.Micro-vascular signs were mostly typesⅡandⅢ,accounting for 78.79%.Conclusion The sub-centimeter pulmonary nodules can be effectively detected by HRCT,and the nodule morphology,density,vascular signs and structural signs such as lobar,burr,vacuole,pleural depression can provide valuable imaging basis and ref
作者
何伟荣
连永伟
王海
林杨皓
李剑明
廖志东
HE Weirong;LIAN Yongwei;WANG Hai;LIN Yanghao;LI Jianming;LIAO Zhidong(Department of Medical Imaging,Meizhou Hospital of Traditional Chinese Medicine,Guangdong,Meizhou 514071,China;Department of Thoracic Surgery,Meizhou Hospital of Traditional Chinese Medicine,Guangdong,Meizhou 514071,China;Department of Pathology,Meizhou Hospital of Traditional Chinese Medicine,Guangdong,Meizhou 514071,China)
出处
《中国医药科学》
2022年第3期149-152,共4页
China Medicine And Pharmacy
基金
广东省梅州市社会发展科技计划项目(2020B070)。
关键词
亚厘米肺结节
微小浸润型肺癌
高分辨率CT
病理
Sub-centimeter pulmonary nodules
Micro-invasive lung cancer
H igh-resolution CT
Pathology
