目的:分析混合性磨玻璃结节样腺癌的多层螺旋CT(MSCT)表现,为肺腺癌的诊断及鉴别提供有价值的影像学特征.方法:选取2013年1月至2015年10月南通大学附属海安县人民医院收治的112例混合性磨玻璃结节样腺癌患者(观察组)及80例混合性磨玻璃结节样肺炎性病变患者(对照组),比较两组的MSCT特征(胸膜凹陷、血管聚集征、边界清晰、分叶及晕厚度),以及不同类型肺腺癌的MSCT特征(密度、部位、数量、大小及形状).结果:观察组胸膜凹陷、血管聚集征、边界清晰、分叶及晕厚度不均的比例均显著高于对照组(均P＜0.05).不同类型的混合性磨玻璃结节样腺癌的密度、部位、数量、大小及形状比较差异均有统计学意义(均P＜0.05).原位腺癌、浸润性腺癌表现为接近同层面的血管的比例高,中心性、偏中心性生长,多为单发,直径＞5 mm,呈点状或多边形、不规则形;微浸润腺癌表现为低于同层面血管比例高、偏中心性生长、多为多发、直径＜5 mm、呈圆形和椭圆形.结论:MSCT的影像学特征有助于肺部混合性磨玻璃结节样腺癌的鉴别和诊断.%Objective:To analyze the multi-slice spiral CT (MSCT) manifestation of lung adenocarcinoma with mixed ground-glass opacity (MGGO).Methods:112 lung adenocarcinoma patients with MGGO in our hospital from January 2013 to October 2015 were recruited as an observation group,and 80 pneumonia patients with MGGO were also selected as a control group.MSCT features including pleural indentation,vascular syndrome,clear boundary,lobulation and halo signs were compared between the two groups.Results:The proportions of pleural indentation,vascular syndrome,clear boundary,and halo sign of lung adenocarcinoma were significantly higher in the observation group than those in the control group (P ＜0.05).There were significant differences in the density,location,quantity,size and shape among adenocarcinoma in situ (AIS),minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC)with MGGO (P ＜0.05).The solid components in AIS and IAS mainly appeared with higher portion of vessels located in the close layers,central or eccentric growth,single nodule,diameter ＞5 mm,dotted or polygonal,irregularly shaped.The solid nodules were usually with higher proportion of vascular located in the lower layers,eccentric growth,multiple nodules,diameter ＜5 mm,round and oval shaped in MIA.Conclusion:MSCT characteristics might help to identify and diagnose lung adenocarcinoma with MGGO.
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