毛刺征聯合血管集束征在肺磨玻璃樣結節(jié)良惡性鑒別診斷中的應用價值

【摘要】 目的：探究毛刺征聯合血管集束征在肺磨玻璃樣結節(jié)良惡性鑒別中的應用價值。方法：選取新余市人民醫(yī)院2019年4月—2022年4月收治的113例肺磨玻璃樣結節(jié)患者，入院后均進行多層螺旋CT（MSCT）檢查，按照穿刺或術后病理活檢結果將其分為良性組（n=45）和惡性組（n=68）。比較兩組患者一般臨床資料及MSCT影像學特征，以穿刺或術后病理活檢結果為金標準，比較毛刺征、血管集束征單獨及聯合診斷惡性肺磨玻璃樣結節(jié)的準確度、敏感度、特異度。結果：兩組患者的性別、年齡及吸煙史比較，差異均無統計學意義（Pgt;0.05）；惡性組腫瘤家族史占比高于良性組，差異有統計學意義（Plt;0.05）。與良性組相比，惡性組結節(jié)高密度、形狀不規(guī)則、邊界粗糙、毛刺征、血管集束征、胸膜凹陷征占比均更高，病灶直徑更長，差異均有統計學意義（Plt;0.05）。毛刺征、血管集束征單獨及聯合診斷的敏感度比較，差異無統計學意義（Pgt;0.05）；毛刺征、血管集束征單獨及其聯合診斷的特異度、準確度比較，差異均有統計學意義（Plt;0.05），且聯合診斷的特異度、準確度均高于單一診斷（Plt;0.05）。結論：惡性肺磨玻璃樣結節(jié)的毛刺征和血管集束征顯示率均高于良性結節(jié)，其聯合診斷效果良好，能有效鑒別結節(jié)的良惡性。

【關鍵詞】 肺磨玻璃樣結節(jié) 多層螺旋CT 毛刺征 血管集束征

Application Value of Spicule Sign Combined with Vascular Cluster Sign in Differential Diagnosis of Benign and Malignant of Pulmonary Ground-glass Nodule/LIAO Jian， RUAN Jiugen， XIAO Qiong. //Medical Innovation of China， 2023， 20（31）： -137

[Abstract] Objective： To investigate the application value of spicule sign combined with vascular cluster sign in differential diagnosis of benign and malignant of pulmonary ground-glass nodule. Method： A total of 113 patients with pulmonary ground-glass nodule admitted to Xinyu People's Hospital from April 2019 to April 2022 were selected. Multislice spiral computed tomography （MSCT） examination was performed after admission， and they were divided into benign group （n=45） and malignant group （n=68） according to puncture or postoperative pathological biopsy result. The general clinical data and MSCT imaging features of the two groups were compared. Taking the result of puncture or postoperative pathological biopsy result as the gold standard， the accuracy， sensitivity and specificity of spicule sign and vascular cluster alone and combination in the diagnosis of malignant pulmonary ground-glass nodule were compared. Result： There were no significant differences in gender， age and smoking history between the two groups （Pgt;0.05）. The proportion of family history of tumor in the malignant group was higher than that in the benign group， the difference was statistically significant （Plt;0.05）. Compared with the benign group， the proportions of nodule with hyperdensity， irregular shape， roughness demarcation， spicule sign， vascular cluster sign and pleural indentation sign in malignant group were higher， and the focus diameter in malignant group was longer， the differences were statistically significant （Plt;0.05）. There was no significant difference in sensitivity between spicule sign， vascular cluster sign alone and combination diagnosis （Pgt;0.05）. There were statistically significant differences in the specificity and accuracy of spicule sign， vascular cluster sign alone and combination diagnosis （Plt;0.05）， and the specificity and accuracy of combination diagnosis were higher than that of single diagnosis （Plt;0.05）. Conclusion： The display rate of spicule sign and vascular cluster sign of malignant pulmonary ground-glass nodule is higher than that of benign nodule， and the combination diagnosis effect is good， which can effectively distinguish benign and malignant nodule.

[Key words] Pulmonary ground-glass nodule Multislice spiral computed tomography Spicule sign Vascular cluster sign

First-author's address： Xinyu People's Hospital， Jiangxi Province， Xinyu 338000， China

doi：10.3969/j.issn.1674-4985.2023.31.031

近年來，隨著國家工業(yè)化的不斷發(fā)展，人們生活環(huán)境污染不斷加重，導致肺癌的發(fā)生率逐漸增加，現已成為嚴重危害我國公民身體健康的惡性腫瘤之一[1-2]。肺磨玻璃結節(jié)是臨床較為常見的一種影像學表現，可在胸部CT掃描中觀察到，在肺部呈現出模糊的、灰白色的、不透明的顆粒狀、結節(jié)狀或膜狀影像[3]。……