Gao Feng, Li Ming, Sun Yingli, Xiao Li, Hua Yanqing
Department of Radiology Diagnostic and Treatment Center of Lung Small Nodules Department of Pathology, Huadong Hospital affiliated with Fudan University, Shanghai, China.
Medicine (Baltimore). 2017 Oct;96(43):e7742. doi: 10.1097/MD.0000000000007742.
This study aimed to explore the value of contrast-enhanced computed tomography (CT) scans in the differential diagnosis of atypical adenomatous hyperplasia, adenocarcinoma in situ, minimal invasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC), which manifested as ground glass nodules (GGNs) or mixed GGNs.Unenhanced and contrast-enhanced presurgical CT images of 136 cases of GGNs were compared. The nodules were diagnosed based on their solid portions and maximum dimensions, and the findings obtained using both contrast-enhanced and unenhanced CT images were analyzed in corroboration with the pathological diagnosis.Most (53/56) preinvasive nodules showed increased mean CT values after contrast administration. In the MIA group, after contrast administration, enlargements of the solid portions were seen in 48 nodules (48/60), and the elevation of the mean CT value was observed in 12 nodules (12/60). The vast majority of IAC nodules (29/30) showed enlargement of the solid portions after contrast administration. Moreover, for group differences, findings obtained using this approach statistically match the pathological findings.Contrast-enhanced CT scans are more useful than unenhanced CT scans for the diagnosis of GGNs, especially for pure GGNs, before surgery.
本研究旨在探讨对比增强计算机断层扫描（CT）在表现为磨玻璃结节（GGN）或混合性GGN的非典型腺瘤样增生、原位腺癌、微浸润腺癌（MIA）和浸润性腺癌（IAC）鉴别诊断中的价值。比较了136例GGN患者术前平扫及对比增强CT图像。根据结节实性部分及最大径进行诊断，并结合病理诊断分析对比增强及平扫CT图像的表现。大多数（53/56）浸润前结节在注射对比剂后平均CT值升高。在MIA组中，注射对比剂后，48个结节（48/60）实性部分增大，12个结节（12/60）平均CT值升高。绝大多数IAC结节（29/30）在注射对比剂后实性部分增大。此外，对于组间差异，采用该方法获得的结果在统计学上与病理结果相符。对比增强CT扫描在术前诊断GGN，尤其是纯GGN方面比平扫CT扫描更有用。
