Yue X, Liu S, Liu S, Yang G, Li Z, Wang B, Zhou Q
Shandong Medical Imaging Research Institute, Shandong University, Shandong, China; Department of Radiology, Weifang Respiratory Disease Hospital, Shandong, China.
Department of Cardiology, Weifang People's Hospital, Shandong, China.
Clin Radiol. 2018 Apr;73(4):411.e7-411.e15. doi: 10.1016/j.crad.2017.11.014. Epub 2017 Dec 19.
To differentiate retrospectively the morphological characteristics at high-resolution computed tomography (CT) between minimally invasive pulmonary adenocarcinoma (MIA) and invasive pulmonary adenocarcinoma (IAC) appearing as subsolid nodules (SNs) with a diameter of ≤3 cm and to provide information to help operative decision-making.
The patient notes of 260 patients with SNs of ≤3 cm in diameter (98 with MIA and 162 with IAC) confirmed at surgery and histopathology from September 2008 to June 2012 were reviewed retrospectively at the Department of Radiology, Weifang Respiratory Disease Hospital. Sixty-seven patients had pure ground-glass nodules (PGGNs) and 193 had mixed ground-glass nodules (MGGNs). Patients were grouped according to the final pathology: minimally invasive MIA and IAC. The HRCT characteristics were compared between the two groups.
There were statistically significant differences in the pattern, shape, diameter of solid components, proportion of solid components, CT radiodensity values of the ground-glass and solid components, borders, margins, air bronchograms, microvascular signs, and pleural indentations of the nodules between the two groups (all p<0.05). Multivariate and receiver operating characteristic (ROC) analyses indicated significant predictors of MIAs were as follows: small lesion diameter (≤14.7 mm), solid components ≤7 mm, <50% of solid components, low CT radiodensity values of the solid components (≤-107 HU), air bronchograms in the ground-glass opacity components, and microvascular signs.
The morphological characteristics at high-resolution CT can be used to differentiate between MIAs and IACs appearing as SNs with a diameter of ≤3 cm and provide information to help operative decision-making.
回顾性鉴别直径≤3 cm的亚实性结节（SNs）表现的微浸润性肺腺癌（MIA）和浸润性肺腺癌（IAC）在高分辨率计算机断层扫描（CT）上的形态学特征，并提供有助于手术决策的信息。
回顾性分析2008年9月至2012年6月在潍坊呼吸病医院放射科确诊的260例直径≤3 cm的SNs患者（98例MIA和162例IAC）的病历，这些患者均经手术及组织病理学证实。67例患者为纯磨玻璃结节（PGGNs），193例为混合磨玻璃结节（MGGNs）。根据最终病理结果将患者分为微浸润性MIA和IAC两组，比较两组的高分辨率CT特征。
两组结节在形态、形状、实性成分直径、实性成分比例、磨玻璃和实性成分的CT密度值、边界、边缘、空气支气管征、微血管征及胸膜凹陷等方面差异均有统计学意义（均p<0.05）。多因素及受试者操作特征（ROC）分析表明，MIA的显著预测因素如下：病变直径小（≤14.7 mm）、实性成分≤7 mm、实性成分<50%、实性成分CT密度值低（≤-107 HU）、磨玻璃密度成分内有空气支气管征及微血管征。
高分辨率CT的形态学特征可用于鉴别直径≤3 cm的SNs表现的MIA和IAC，并提供有助于手术决策的信息。
