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目的:探讨恶性微小孤立性肺结节(SPN)的影像学特征。方法:收集我院门诊就诊经术后病理证实的恶性SPN患者81例,回顾性分析其SPN的影像学特征。结果:81例恶性SPN患者中纯磨玻璃样结节(p GGO)21例,混合性结节(m GGO)24例,实性结节(SN)36例。分叶征及胸膜凹陷征在p GGO中的检出率低于m GGO和SN(χ~2分别为21.13、28.56,均P<0.001),随着结节实性成分增多,密度增高,分叶征及胸膜凹陷征也更明显(趋势χ~2分别为18.64、28.28,均P<0.001)。而毛刺、支气管充气征和血管集束征在3种类型恶性SPN中检出率均较高,但组间差异无统计学意义(P>0.05)。结论:3种类型恶性SPN的影像学特征各有不同,而血管集束征在3种类型恶性SPN中检出率均较高,评判SPN与血管之间的关系对肺微小结节的良恶性鉴别可能更有价值。
Objective: To investigate the imaging features of malignant solitary pulmonary nodules (SPN). Methods: A total of 81 patients with malignant SPN confirmed by pathology in our outpatient clinic were collected. The imaging features of SPN were retrospectively analyzed. Results: Among the 81 patients with malignant SPN, 21 were purely ground glassy nodules (pGGO), 24 were mixed nodules (mGGO) and 36 were solid nodules (SN). The detection rate of lobulation and pleural indentation in pGGO was lower than that of mGGO and SN (χ ~ 2 = 21.13 and 28.56, respectively, P <0.001). With the increase of nodule solidity and density, Ye Zheng and pleural indentation signs are more obvious (trend χ ~ 2, respectively, 18.64,28.28, both P <0.001). The detection rates of burr, bronchial airway and vascular bundles were higher in all three types of malignant SPN, but there was no significant difference between the two groups (P> 0.05). CONCLUSION: The imaging features of the three types of malignant SPN are different, and the clustering of blood vessels in the three types of malignant SPN were detected in high rates, the relationship between SPN and blood vessels to determine the relationship between benign and malignant pulmonary nodules May be more valuable.