CT薄层靶重建技术对肺内磨玻璃密度小结节的诊断价值

摘要

目的 探讨CT薄层靶重建技术对肺内磨玻璃密度小结节(sGGN)的诊断价值.方法 回顾分析本院109例经术后病理或随访证实的肺内sGGN患者临床及影像资料,其中良性组23例,原位腺癌组21例、微浸润腺癌组29例、浸润腺癌组36例,对比分析CT薄层靶重建技术对肺内sGGN的良恶性的诊断价值及CT征象检出的相关性.结果 薄层靶重建技术较常规重建技术能显著提高肺内sGGN的诊断效能,对恶性结节的诊断符合率、受试者工作特征曲线(ROC曲线)的曲线下面积(AUC)、敏感性、特异性分别为85.32％、0.679、90.80％、63.64％;良性结节分别为77.06％、0.764、83.72％、52.17％.薄层靶重建技术在原位腺癌、微浸润腺癌组实性成分、晕征、毛刺征、胸膜凹陷征、分叶征及浸润腺癌组实性成分、晕征、胸膜凹陷征、分叶征的CT征象检出率均大于常规重建技术,差异有统计学意义(P＜0.05).结论 CT薄层靶重建技术能提高肺内sGGN的CT诊断价值.%Objective To investigate the diagnostic value of CT thin-section target reconstruction technique in patients with pulmonary small size groud glass nodules (sGGN).Methods A total of 109 patients with pulmonary sGGN certified post-operation and/or follow up were analyzed retrospectively,and the clinical and CT images of all patients were completely collected.There were 23 cases of benign group,21 cases of adenocarcinoma in situ group,29 cases of minimally invasive adenocarcinoma group and 36 cases of invasive adenocarcinoma group,respectively.The differential diagnostic value using CT thin-section target reconstruction technique was analyzed between the benign and malignant pulmonary sGGN groups,and the CT feature detection rates were compared between CT thin section target and common reconstruction techniques.Results The CT thin-section target reconstruction technique had improved the diagnostic efficiency of pulmonary sGGN.The diagnostic accuracy,area under curve(AUC),sensitivity and specificity were 85.32 ％,0.679,90.80 ％,63.64 ％ in malignant group and 77.06％,0.764,83.72％,52.17％ in benign pulmonary sGGN group,respectively.The CT features as solid component in whole nodule,"halo sign",speculation sign,pleural retraction sign,lobulation sign were more detected by using the thin-section target reconstruction technique than that by using the common reconstruction among adenocarcinoma in situ group,minimally invasive adenocarcinoma group and invasive adenocarcinoma group (P＜0.05) but not speculation sign in the invasive adenocarcinoma group(P=0.126).Conclusion The CT thin section target reconstruction technique can improve the diagnostic value of pulmonary sGGN.