Zhu Yanyan, Hou Dailun, Lan Meihong, Sun Xiaoli, Ma Xiangxing
Division of Computed Tomography, Department of Radiology, Shandong University School of Medicine, Shandong Provincial Third Hospital, Jinan 250031, China.
Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Quant Imaging Med Surg. 2019 Jun;9(6):1087-1094. doi: 10.21037/qims.2019.06.09.
The aim of this study was to determine whether the clinical value of scanned computed tomography (CT) images is higher when using ultra-high-resolution CT (U-HRCT) target scanning than conventional CT target reconstruction scanning in the evaluation of ground-glass-nodule (GGN)-like lung adenocarcinoma.
A total of 91 consecutive patients with isolated GGN-like lung adenocarcinoma were included in this study from April 2017 to June 2018. U-HRCT and conventional CT scans were conducted in all enrolled patients. Two experienced thoracic radiologists independently assessed image quality and made diagnoses. Based on the pathological results, the accuracies of U-HRCT target scanning and conventional CT target reconstruction for detecting morphological features on CT, including spiculation of GGNs, bronchial vascular bundles, solid components in the nodules, burr, vacuole, air bronchial signs, and fissure distortion, were calculated. All statistical analyses were performed using SPSS 17.0 software. Enumeration data were tested using the Chi-square test. A P value of <0.05 was considered statistically significant.
When both techniques were compared with the pathological findings, the detection rate for CT images obtained using U-HRCT target scanning and conventional CT target reconstruction with regard to the spiculation of GGNs, bronchial vascular bundles, and solid components in the nodules were 78% . 61.5%, 72.5% . 54.9%, 65.9% . 49.5%, respectively. The presence of the spiculation of GGNs, bronchial vascular bundles, and solid components in the nodules in U-HRCT target scanning was significantly higher than that in conventional CT target reconstruction (all P<0.05). However, no significant difference was observed between the two techniques with regard to the burr, vacuole, air bronchial signs, and fissure distortion (all P>0.05).
When viewing GGNs, the detection rate was higher for U-HRCT target scanning than for conventional CT target reconstruction, and this improvement significantly enhanced the diagnostic accuracy of early lung adenocarcinoma.
本研究旨在确定在评估磨玻璃结节（GGN）样肺腺癌时，使用超高分辨率CT（U-HRCT）靶扫描与传统CT靶重建扫描相比，扫描的计算机断层扫描（CT）图像的临床价值是否更高。
2017年4月至2018年6月，本研究共纳入91例连续的孤立性GGN样肺腺癌患者。对所有入组患者进行U-HRCT和传统CT扫描。两名经验丰富的胸科放射科医生独立评估图像质量并做出诊断。根据病理结果，计算U-HRCT靶扫描和传统CT靶重建在CT上检测形态学特征的准确性，包括GGN的毛刺、支气管血管束、结节内实性成分、毛刺、空泡、空气支气管征和叶间裂变形。所有统计分析均使用SPSS 17.0软件进行。计数资料采用卡方检验。P值<0.05被认为具有统计学意义。
当将两种技术与病理结果进行比较时，U-HRCT靶扫描和传统CT靶重建获得的CT图像在GGN的毛刺、支气管血管束和结节内实性成分方面的检出率分别为78%、61.5%、72.5%、54.9%、65.9%、49.5%。U-HRCT靶扫描中GGN的毛刺、支气管血管束和结节内实性成分的存在明显高于传统CT靶重建（所有P<0.05）。然而，在毛刺、空泡、空气支气管征和叶间裂变形方面，两种技术之间未观察到显著差异（所有P>0.05）。
在观察GGN时，U-HRCT靶扫描的检出率高于传统CT靶重建，这种改进显著提高了早期肺腺癌的诊断准确性。
