The Relationship Study On The Multi-detector CT Imaging Findings Of Ground Glass Opacity Nodules And Pathological Classification

Part I The Differential Diagnosis Of The MDCT Features Between thebenign lesions from the malignant or precancerous lesionsAs Ground-glassNodulesObjective:To evaluate different features between MDCT features benign and malignantpulmonary ground-glass opacity nodules (GGNs) on multidetector CT (MDCT),and to obtaintheir significance of differential diagnosis.Methods:95GGNs in93patients pathologically or clinically confirmed GGNs wereretrospectively analysed the pathological data and the MDCT images.To identify thedifferentiating CT features between preinvasive lesions and MIA and to evaluate theirdifferentiating accuracy. Morphological characteristics were analysed by binary logisticregression analysis to estimate the likelihood of malignancy.Results:95GGNs in93patients,32pGGNs,63mGGNs.There were32benign and63malignant or precancerous lesions.No statistical differences were found between benign andmalignant GGNs in terms of age, male-to-female ratio,size and location.Among the CTfindings,The frequency of lobulation,spiculation, well-defined but coarse interface, Welldefined but smooth interface,bronchus cut-off, pleural indentation and vascular convergencewas significantly higher in malignant or precancerous lesions.Ill defined interface and theseptal thickening are seen most frequently in benign GGNs.The shape of the lesions, cavitation/cavity and air-filled bronchiwere of no significant differences between them.Inaddition, Binary logistic regression analysis showed that interface, lobulation,interface,pleuralindentation and the septal thickening or notwere important indicators for differential diagnosisof GGNs,with the corresponding odds ratios of23.995、42.355、17.498and18.600,respectively.Conclusion: Analysis the MDCT imaging findings of GGNs, the interface,lobulation,pleural indentationand the septal thickening or not are helpful in the differentiation of thebenign lesions from the malignant or precancerous lesions appearing as GGNs.Part II The Differential Diagnosis Of The MDCT Features BetweenPreinvasive Lesions And MIA Appearing As Ground-glass NodulesObjective:To retrospectively investigate the differentiating MDCT features betweenpreinvasive lesions and MIA appearing as ground-glass nodules (GGNs),and to obtain theirsignificance of differential diagnosis.Methods: Reviewed and analyzed the pathological data and the MDCT images of the111GGNs in93patients. To identify the differentiating CT features between preinvasive lesionsand MIA and to evaluate their differentiating accuracy.In addition, receiver operatingcharacteristic (ROC) curve analysis was performed,respectively.Results:38GGNs in27preinvasive lesions patients and73GGNs in66MIA patients wereincluded in this study.The age, male-to-female ratio and lesion multiplicity were of nostatistical differences between preinvasive lesions and MIA.There were significant differencesin lesion size,solid portion size and solid proportion(P＜0.05).The optimal cut-off value forlesion size and solid proportion for differentiating preinvasive lesions from MIA was13mmor less(sensitivity,82.90%; specificity,80.25%),2.0mm or less （sensitivity,90.00%;specificity,97.00%）and12.25%or less (sensitivity,88.00%;specificity,97.00%), respectively.Preinvasive lesions were more frequently nonlobulated and nonspiculated than MIA(P0.05).Among the CT findings,vacuole sign,bubble lucency and pleural retraction were of nosignificant differences between preinvasive lesions and MIA (P=0.120、0.380、0.090, respectively).Conclusion: Preinvasive lesions can be accurately distinguished from MIA by the smallerlesion size,smaller solid portion size and solid proportion,nonlobulated border andnonspiculated margin.