| Objective:Retrospective analysis and comparative study CT manifestation of groundglass pulmonary nodule(GGN)of inflammation,pre-invasion and invasive adenocarcinoma imaging findings and features.To Discussion contribute to the differential diagnosis of the three by CT features and laws,designed to further improve the level of diagnosis and differential diagnosis.Material and methods:Total of 147 patients with 148 GGN(solitary GGN has 146,only 1 patient simultaneously exist two GGN and belong to the group of inflammatory lesions)were collected by Dalian University Affiliated Zhongshan Hospital from October 2010 to December 2015.All diameters of GGN less than 30 mm,and all GGNs were obtained and confirmed by clinical pathology or imaging follow-up.Inflammatory lesions in 38 cases,aged 23-72 years,mean 54.4 ± 11.9 years.Pre-invasive lesions in 56 cases(atypical adenomatous hyperplasia in 19 cases,adenocarcinoma in situ in 37 cases),aged 24-77 years,mean 51.5 ± 10.3.invasive adenocarcinoma lesions in 54 cases(minimally invasive adenocarcinoma in 15 cases,invasive adenocarcinoma in 39cases),aged 25-80,mean 57.2 ± 11.8 years.All the patients accepted MSCT scaning under the same condition parameters,CT equipment include: German Siemens Somatom Definition dual source CT,Somatom Definition AS64 rows CT.Two highly qualified radiologist of chest evaluate CT features of GGNs,include: lesion location,size,morphology,interface,speculation,lobulation,vacuole sign,air-bronchogram,pleural indentation sign,and the relationship between GGN and vascular.Thw data were analyzed statistically by SPSS17 0 software,?=0.05,p <? as statistically significant difference.multiple comparisons should adjust test standards becomes ?? by Bonferroni method,??=?/k(k-1)/2,p<?? as statistically significant difference.Results: Inflammatory lesion(38 cases): round 23 cases,well-defined interface 20 cases,speculation 6 cases,lobulation 12 cases,vacuole sign 4 cases,air-bronchograms 5 cases,pleural indentation sign 16 cases.Pre-invasive lesion(56 cases): round 49 cases,welldefined interface 41 cases,speculation 9 cases,lobulation 28 cases,vacuole sign 14 cases,air-bronchograms 6 cases,pleural indentation sign 14 cases.Invasive adenocarcinoma(54 cases): round 35 cases,well-defined interface 41 cases,speculation 11 cases,lobulation 48 cases,vacuole sign 19 cases,air-bronchograms 23 cases,pleural indentation sign 36 cases.Three groups lesions morphology(p = 0.005),interface(p = 0.04),lobulation(p <0.001),vacuole sign(p = 0.027),air-bronchogram(p <0.001),pleural indentation(p <0.001)were significantly different.Inflammatory lesions(p GGN 18 cases,m GGN 20 cases),pre-invasive lesions(p GGN have 33 cases,m GGN 23 cases),invasive adenocarcinoma(p GGN 14 cases,m GGN 40 cases),GGN type among the three groups were a significant statistical difference(p = 0.002).Relationship types between GGN and vascular : inflammatory lesion(? type: 5 cases,? type: 8 cases,? type: 19 cases,? type: 6 cases),invasive disease(? type: 12 cases,? type: 24 cases,? type: 8 cases,? type: 12 cases),invasive adenocarcinoma(type ?: 17 cases,type ?: 12 cases,? type: 25 cases,? type: 0 cases),three groups constitute of the vascular relations were statistically significant differences(p <0.001).Conclusion:1.Comprehensive analysis laws of GGN size,morphology,lobulation,vacuole sign,air-bronchogram and pleural indentation sign and combine with type of GGN are helpful in differential diagnosis of inflammatory lesions,pre-invasive lesions and invasive adenocarcinoma.2.Types of relationship between vascular and GGN are meaningful for Differential Diagnosis of inflammatory lesions,pre-invasive lesions and invasive adenocarcinoma. |
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