Objective: To analyze the CT features in differentiating pre-invasive and invasive lesion appearing as ground-glass nodule (GGN) retrospectively and obtain signs of discrimination. Methods: A total of 122 cases of GGNs were confirmed by pathology, 57 cases were pure GGNs and 65 cases were part solid GGNs. Seventy-one cases of invasive lesions, including 13 cases of atypical adenomatous hyperplasia(AAH) and 58 cases of adenocarcinoma in situ(AIS); invasive lesion in 51 cases, including 39 cases of minimally invasive adenocarcinoma(MIA) and 12 cases of invasive adenocarcinoma(IAC), we analyzed the difference between two groups of CT characteristics, ROC curve was used to identify the two groups of the best cut-off val-ues. Results: In pure GGNs, size and lobulation were significant (P<0.05) and the cut-off of average diameterwas 11.82 mm, sensitivity and specificity were 73% and 87%. In part solid GGN, average diameter, solid proportion grade, lobulation, specu-lation and pleural retraction were statistically significant (P<0.05) and the cut-off value for average diameter in invasive lesion was 12.5 mm, sensitivity and specificity were 75% and 80%. Conclusion: The CT features could be used to pre-assess pre-invasive and invasive lesion appearing as GGN, the important factors are mainly reflected in the average diameter of GGN le-sions, solid components and edge signs.%目的:回顾性分析肺磨玻璃结节(GGN)浸润前病变与浸润性病变的CT表现规律与差别,旨在探寻有助于两者鉴别诊断的有价值征象.方法:收集经病理证实的GGN病例122例,57例为纯GGN(pGGN),65例为混合性GGN(mGGN).浸润前病变71例,包括13例非典型瘤样增生(AAH)和58例原位腺癌(AIS);浸润性病变51例,包括39例微浸润腺癌(MIA)和12例浸润性腺癌(IAC).比较两组CT征象差异,并行ROC曲线分析评估两组鉴别的最佳界值.结果:在pGGN组中,平均直径和分叶征对鉴别浸润前病变与浸润性病变差异有统计学意义(P<0.05),平均直径的界值为11.82 mm,诊断敏感度和特异度为73%和87%.在mGGN中,平均直径、实性比例、分叶征、毛刺征和胸膜凹陷征在两组间差异有统计学意义(P<0.05),平均直径的界值为12.5 mm,诊断敏感度和特异度为75%和80%.结论:基于CT征象是可以对肺部GGN的浸润前与浸润性病变进行预评估,重要因素主要体现在GGN病灶平均直径、实性成分以及边缘征象等.
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