Kitami Akihiko, Kamio Yoshito, Hayashi Shoko, Suzuki Kosuke, Uematsu Shugo, Gen Ryozo, Suzuki Takashi, Kadokura Mitsutaka
Respiratory Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Gen Thorac Cardiovasc Surg. 2012 Jul;60(7):425-30. doi: 10.1007/s11748-012-0066-7. Epub 2012 Jun 1.
Differentiation of atypical adenomatous hyperplasia (AAH), bronchioloalveolar carcinoma (BAC), and invasive carcinoma on computed tomography (CT) is useful for determining "follow-up or resection" strategies for lesions displaying ground-glass opacity (GGO). The purpose of this study is to evaluate one-dimensional quantitative CT values of GGO on high-resolution CT (HRCT) images using computer-aided diagnosis.
Between April 2001 and March 2010, a total of 44 nodules in 42 patients with pure or mixed GGOs ≤2 cm were retrospectively evaluated. Maximum diameter and one-dimensional mean CT (m-CT) value of the diameter were measured using a computer graphics support system (HOPE/DrABLE-EX, Fujitsu, Tokyo, Japan) that displays a CT density profile across the tumor.
m-CT values were -682 ± 64 HU (range) for AAH lesions, -544 ± 179 (range) for Type A lesions, -496 ± 147 (range) for Type B lesions, and -371 ± 142 (range) for invasive lesions. AAH lesions had a significantly lower m-CT value than Type B lesions. AAH, Type A, and Type B lesions had significantly lower m-CT values than invasive lesions (p < 0.05). All seven GGO lesions with a maximum diameter ≤1 cm and m-CT value ≤-600 HU were pre-invasive lesions, while 16 of 22 (73 %) cases with maximum diameter >1 cm and m-CT value >-600 HU were invasive lesions.
Observation may be indicated for GGO lesions with a maximum diameter ≤1 cm and m-CT value ≤-600 HU.
在计算机断层扫描（CT）上鉴别非典型腺瘤样增生（AAH）、细支气管肺泡癌（BAC）和浸润性癌，对于确定表现为磨玻璃影（GGO）的病变采取“随访或切除”策略很有用。本研究的目的是使用计算机辅助诊断评估高分辨率CT（HRCT）图像上GGO的一维定量CT值。
回顾性评估2001年4月至2010年3月期间42例纯GGO或混合GGO且直径≤2 cm的患者中的44个结节。使用计算机图形支持系统（HOPE/DrABLE-EX，富士通，东京，日本）测量最大直径和直径的一维平均CT（m-CT）值，该系统可显示肿瘤的CT密度剖面图。
AAH病变的m-CT值为-682±64 HU（范围），A 型病变为-544±179（范围），B型病变为-496±147（范围），浸润性病变为-371±142（范围）。AAH病变的m-CT值显著低于B型病变。AAH、A型和B型病变的m-CT值显著低于浸润性病变（p < 0.05）。所有7个最大直径≤1 cm且m-CT值≤ -600 HU的GGO病变均为浸润前病变，而22例最大直径>1 cm且m-CT值>-600 HU的病例中有16例（73%）为浸润性病变。
对于最大直径≤1 cm且m-CT值≤ -600 HU的GGO病变，可能需要进行观察。
