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目的探讨MSCT图像中肺亚实性结节与供血血管关系及类型,及其对亚实性结节良恶性诊断的意义。方法对88例GGN进行回顾性分析,观察病灶及周围供血血管形态并进行分类,将亚实性结节与供血血管关系分为四种类型:Ⅰ型血管在GGN旁绕行;Ⅱ型完整的血管穿过GGN;Ⅲ型血管在GGN内扭曲、扩张;Ⅳ型更为复杂的血管表现。将分析结果与手术病理及随诊结果对照。结果 40例亚实性结节病理诊断为恶性结节。40例亚实性结节与供血血管的关系四种类型(Ⅰ~Ⅳ)分别为0,8,21,11例,Ⅲ型最多。11例Ⅳ型均为浸润性腺癌,21例Ⅲ型中17例为浸润性腺癌,其余2例为原位腺癌,2例为微浸润腺癌,Ⅲ型+Ⅳ型为浸润性腺癌的可能性非常大,且四组亚实性结节与供血血管关系类型有统计学意义(χ~2=17.930,P=0.006)。结论多层螺旋CT扫描能清楚显示GGN与其供血血管的关系,其对GGN良恶性性质的诊断和鉴别诊断有重要价值。
Objective To investigate the relationship and type of lung subsolid nodules and blood vessels in MSCT images and their significance in the diagnosis of benign and malignant subsidences. Methods 88 cases of GGN were retrospectively analyzed. The morphology of blood vessels in the lesion and its surroundings were observed and classified. There were four types of subtystous nodules and blood vessels: type Ⅰ vessels bypassing the GGN; type Ⅱ intact Blood vessels pass through GGN; type III blood vessels distort and expand within GGN; type IV more complex vascular manifestations. The analysis results and surgical pathology and follow-up results of the control. Results 40 cases of sub-solid nodules were diagnosed as malignant nodules. There were four types (Ⅰ ~ Ⅳ) of 0 cases in 0, 40, 81, and 11 cases, respectively, with the highest type Ⅲ in 40 cases of subacute nodules and blood vessels. 11 cases of type Ⅳ were invasive adenocarcinoma, 21 cases of type Ⅲ in 17 cases of invasive adenocarcinoma, the remaining 2 cases of adenocarcinoma in situ, 2 cases of micro-invasive adenocarcinoma, type Ⅲ + Ⅳ invasive adenocarcinoma may be The sex is very large, and the four types of subsolid nodules and blood vessels have a statistically significant relationship (χ ~ 2 = 17.930, P = 0.006). Conclusions Multi-slice spiral CT scan can clearly show the relationship between GGN and its blood supply vessels, which is of great value in diagnosis and differential diagnosis of benign and malignant GGN.