Nagao Michinobu, Murase Kenya, Yasuhara Yoshifumi, Ikezoe Junpei, Eguchi Kenji, Mogami Hiroshi, Mandai Koichi, Nakata Masao, Ooshiro Yumi
Department of Radiology, Matsuyama Medical Center for Cancer and Cardiovascular Disease, Ehime, Japan.
Invest Radiol. 2002 Dec;37(12):692-7. doi: 10.1097/00004424-200212000-00009.
This study was to measure localized ground-glass attenuation (GGA) in the peripheral lung on thin-section computed tomography (CT) and to assess any relationship between the attenuation and lesion.
Twenty-eight surgically resected tumors with localized GGA at thin-section CT were studied. The tumors were histologically diagnosed as 8 atypical adenomatous hyperplasia (AAH), 11 bronchioloalveolar carcinoma (BAC), and 9 BAC with fibrosis. We assumed three concentric circles, which were 0.8, 1.0, and 1.2 times the diameter of each tumor and measured the average CT values corresponding to inside each circle. We calculated a difference in CT value between 0.8 and 1.2 times the diameter of the tumor and defined as the contrast index.
The contrast index for tumors with AAH, BAC, and BAC with fibrosis were 19.8 +/- 8.3, 42.5 +/- 16.0 (P < 0.05 vs. group with AAH), and 111.4 +/- 32.6 (P < 0.0001 vs. Group with BAC), respectively. The contrast index became greater in the stepwise progression from AAH to BAC and from BAC to BAC with fibrosis.
The contrast index correlated histologic findings of the tumor growth in BAC. The contrast index may be a useful and objective measurement for determining surgical treatment for localized GGA in preoperative diagnosis.
本研究旨在通过薄层计算机断层扫描（CT）测量外周肺局部磨玻璃影（GGA），并评估磨玻璃影与病变之间的关系。
对28例经手术切除且薄层CT表现为局部GGA的肿瘤进行研究。这些肿瘤经组织学诊断为8例不典型腺瘤样增生（AAH）、11例细支气管肺泡癌（BAC）和9例伴有纤维化的BAC。我们假定三个同心圆，其直径分别为每个肿瘤直径的0.8倍、1.0倍和1.2倍，并测量每个圆内对应的平均CT值。我们计算肿瘤直径0.8倍和1.2倍处CT值的差值，并将其定义为对比指数。
AAH、BAC和伴有纤维化的BAC肿瘤的对比指数分别为19.8±8.3、42.5±16.0（与AAH组相比，P<0.05）和111.4±32.6（与BAC组相比，P<0.0001）。从AAH到BAC以及从BAC到伴有纤维化的BAC，对比指数呈逐步升高。
对比指数与BAC肿瘤生长的组织学表现相关。对比指数可能是术前诊断中确定局部GGA手术治疗的一种有用且客观的测量方法。
