Li Shanshan, Yu Jinming, Meng Xue, Liu Lingfei, Xu Liang, Liu Liheng, Yu Haiying, Gao Yongsheng, Zhang Zhen
Shandong University, Shandong Cancer Hospital and Institute, 44 Wenhua West Road, Ji'nan, Shandong, 250117, People's Republic of China.
Liaocheng Traditional Chinese Medicine Hospital, 1 Culture Road, Dongchangfu district, Liaocheng, Shandong, 252000, People's Republic of China.
J Cardiothorac Surg. 2020 Jul 6;15(1):162. doi: 10.1186/s13019-020-01159-2.
Invasive pure ground-glass opacity and pre-invasive pure ground-glass opacity have different 5-year overall survival rate and risk of lymph node metastasis and the extent of resection. It is difficult to discriminate these nodules since they share similar CT features and may occur concurrently. The objectives of this study were to investigate the feasibility of non-contrast enhanced plus contrast-enhanced computed tomography in discriminating invasive pure ground-glass opacity from pre-invasive pure ground-glass opacity.
We retrospectively examined 90 patients with pure ground-glass opacity who underwent non-contrast enhanced and contrast-enhanced CT according to a simplified protocol (one non-contrast enhanced measurement and two contrast-enhanced measurements at 30 s and 60 s after contrast injection) from 2015 to 2019. All imaging examinations were analyzed using three-dimensional computer-aided volume. Two independent samples t tests, one-way analysis of variance, chi-square test and logistic regression were used for analysis. A receiver operating characteristic curve was used to determine the optimal cut-off value of mean CT attenuation for differentiation of groups and to obtain diagnostic value.
(1) The CT values of one non-contrast-enhanced, two contrast-enhanced and volume measurements between two groups had statistically significant differences (P < 0.001). (2) At the 30-s scan, there were more nodules in the pre-invasive group with no enhancement than in the pre-invasive group, which was statistically significant. (3) The CT value of 60-s scan was independent predictor of invasive adenocarcinoma (P = 0.019).
Non-contrast enhanced plus two contrast-enhanced CT based on volume measurements can differentiate invasive pGGO from pre-invasive pGGO.
侵袭性纯磨玻璃密度影和浸润前纯磨玻璃密度影在5年总生存率、淋巴结转移风险及切除范围方面存在差异。由于这些结节具有相似的CT特征且可能同时出现，因此难以鉴别。本研究的目的是探讨非增强加增强计算机断层扫描在鉴别侵袭性纯磨玻璃密度影和浸润前纯磨玻璃密度影方面的可行性。
我们回顾性研究了2015年至2019年期间90例接受非增强和增强CT检查的纯磨玻璃密度影患者，检查按照简化方案进行（一次非增强测量以及在注射造影剂后30秒和60秒进行两次增强测量）。所有影像检查均采用三维计算机辅助容积分析。采用两独立样本t检验、单因素方差分析、卡方检验和逻辑回归进行分析。使用受试者工作特征曲线确定平均CT衰减的最佳截断值以区分组别并获得诊断价值。
（1）两组之间一次非增强、两次增强及容积测量的CT值存在统计学显著差异（P < 0.001）。（2）在30秒扫描时，浸润前组中无强化的结节比侵袭组更多，差异有统计学意义。（3）60秒扫描的CT值是侵袭性腺癌的独立预测因素（P = 0.019）。
基于容积测量的非增强加两次增强CT能够区分侵袭性纯磨玻璃密度影和浸润前纯磨玻璃密度影。
