表现为纯磨玻璃影的原位腺癌及微浸润腺癌CT鉴别诊断.doc

表现为纯磨玻璃影的原位腺癌及微浸润腺癌CT鉴别诊断
　　[摘要] 目的 探讨表现为纯磨玻璃结节影（pure ground-glass nodules，pGGONs）的原位腺癌（adenocarcinoma in situ，AIS）及微浸润腺癌（minimally invasive adenocarcinoma，MIA）的不同CT特征及二者之间的鉴别诊断。 方法 回顾性分析CT表现为pGGONs并且经手术后病理证实的76例AIS、26例MIA的术前CT及临床资料，CT特征包括病灶最大径、平均CT值、病灶的形态、穿过病灶的血管走行、空气支气管征。 结果 AIS组的平均CT值为（-±）HU，MIA组的CT值为（-±）HU，两者比较差异有统计学意义；AIS组的最大径约（±）cm，MIA组的最大径约（±）cm，差异有统计学意义（P<）；两组结节形态、穿过结节的血管走行之间的差异有统计学意义；而两组空泡征之间的差异无统计学意义；利用结节的最大径、平均CT值及穿过结节的血管走行联合判断结节的病理类型，可以更好提高诊断价值。 结论 应用结节的最大径、平均CT值及穿过结节的血管走行可以鉴别表现为pGGONs 的AIS及MIA。
　　[关键词] 肺腺癌；磨玻璃影；原位腺癌；微浸润腺癌；病理学
　　[中图分类号] ； [文献标识码] B [文章编号] 1673-9701（2015）34-0107-04
　　Differentiation between adenocarcinoma in situ and minimally invasive adenocarcinoma in CT menifestied as pure ground-glass nodules
　　FAN Yanfen1 WANG Mei1 CAO Hanbo1 ZHANG Shanhua1 WANG Shanjun1 WANG Zhaoyu2 ZHANG Yongkui3
　　 of Radiology， Zhoushan Hospital in Zhejiang Province， Zhoushan 316004， China； of Pathology， Zhoushan Hospital in Zhejiang Province， Zhoushan 316004，China； of Thoracic Surgery， Zhoushan Hospital in Zhejiang Province， Zhoushan 316004，China
　　[Abstract] Objective To study the computed tomography features of patients of pure ground-glass nodules（GGONs） to distinguish AIS from MIA. Methods 76 AIS and 26 MIA were proved by surgery and pathology underwent CT scan before treament. CT characteristics of these pGGNs and pathological grading were analyzed retrospectively，CT manifestations including lesion maximum diameter， average CT attenuation，shapes，leision vesseles，air-containing. Results The average CT attenuation of the AIS were（-
±）HU，the average CT attenuation of the MIA were （-±）HU；the maximum diameter of AIS were （±）cm， the maximum diameter of MIA were（±）cm； There was obvious difference between the two groups（P<）， with statistical significance. There were statistically significant in lesion shapes， l