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

Part Ⅰ The Differential Diagnosis Of The MDCT Features Between the benign lesions from the malignant or precancerous lesions As Ground-glass NodulesObjective:To retrospectively investigate the differentiating HRCT features between lung cancer and pulmonary inflammation as ground-glass nodules (GGNs),and to obtain their significance of differential diagnosis.Methods:Reviewed and analyzed the HRCT images of the 80 GGNs in 80 patients.To identify the differentiating CT features of the GGNs between lung cancer and inflammation and to evaluate their differentiating accuracy.Results:80 cases GGNs, of which 21 cases of lung inflammation (9 pGGNs and 12 mGGNs),59 cases of lung cancer (14 pGGNs and 45 mGGNs), including nine cases of adenocarcinoma in situ, microinvasive adenocarcinoma 12 cases,35 cases of adenocarcinoma and adenosquamous carcinoma 3cases. The statistical analysis showed that 80 cases GGNs patients, pneumonia and lung lesions in age (P=0.139), sex ratio (P=0.602), tumor size (P=0.593) and location (P=0.626) between the relatively The difference was not statistically significant. Among the CT findings,The frequency of lobulation,spiculation, well-defined but coarse interface,broncHUs cut-off, pleural indentation and vascular convergence was significantly higher in lung cancer.The shape of the lesions, Well defined but smooth interface, cavitation/cavity and air-filled bronchiwere of no significant differences between them (P=0.717、0.162、0.130、0.393,respectively).Conclusion:Analysis the HRCT imaging findings of GGNs, the interface (Ill defined, well-defined but coarse),lobulation, spiculation,broncHUs cut-off,pleural indentation,vascular convergence and the septal thickening or not are helpful in the differentiation of lung cancer from pulmonary inflammation,dynamic observation of the imaging changes can improve the diagnostic accuracy of GGNs.Part Ⅱ1 CT attenuation value in the differential diagnosis of lung cancer and preinvasive lesionsObjective:A retrospective analysis of the performance of pure ground-glass density nodules (pGGNs) precancerous lung adenocarcinoma:atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS) CT attenuation values lung window unenhanced conditions the presence or absence of significant difference, and try to come to be able to identify CT average of the two.Methods:A total of 60 patients with 62 lesions pGGNs pathological data were retrospectively analyzed, and the use of semi-automatic outline PHILIPS Lung Nodule Assessment measured lesions in average CT value (HU) and the maximum diameter (mm). Differences between groups use Bland-Altman method for analysis. Using independent samples t-test to compare the maximum diameter and the CT value statistics; ROC curve to obtain the critical value and compare the merits of means between the two measurements. Statistical analysis software spss 17.0.Results:62 pGGNs include:24 atypical adenomatous hyperplasia (AAH),38 adenocarcinoma in situ (AIS).38 of which are all non-mucinous adenocarcinoma in situ and its clinical TMN staging are T1N0M0. Age, sex ratio there was no statistical difference in differentiating AAH and AIS. Its P values were 0.058,0.275. The maximum diameter of the lesion to identify the performance of GGNs of AAH and AIS have statistically significant P value of 0.001. Bland-Altman analysis showed that 95 percent of the consistency limits of 0.992 (0.93,1.09), reproducible measurement results twice GGNs density difference of 6% to 7%, in clinical practice, the differences can be accepted. The average value of CT AAH AAH was -739±50HU (95% CI:-760～-717), range (-805～-643) was significantly less than the AIS:-638±78HU (95% CI:-664～-612), range (-789～-546) (P=0.001). ROC curves show:the area under the curve (AUC)=0.916, AAH and AIS to identify optimal boundary value-688HU (sensitivity=88.48% specificity=94.43%)Conclusion:Lung window CT scan condition values can help clinicians to identify manifestations of pGGNs precancerous lesions, the optimal cutoff value -688HU. Its specificity and sensitivity are better than the maximum diameter of the axial measurements.2 CT attenuation value in the differential diagnosis of MIA and LPA lesionsObjective:try to study the attenuation value of CT plain scan and enhanced scan usingth e measurement of pulmonary window conditions CT, ground glass density range of mixed pulmonary window conditions (mGGNs) ground glass components of the enhanced feature s,and to observe whether the pathological type and.methods:2012.8.1～2013.8.1 findings mGGNs≤3cm, confirmed by pathology of micro-inv asive or invasive adenocarcinoma lesions of 82 patients underwent plain and dynamic en hanced scanning, GGO composition was observed in mGGO in lung window conditions h ave no change in each period. And on the basis of GGO component size will be divided into subtypes 4 organizations, observe the differences between its content and pathology.Results:GGO component of mGGO and actually strengthen the way of compon-ent simila rity. Enhanced 120s scan GGO components when the CT value reach-es the maximum va lue. Except for rare variant, GGO accounts for the component ratios and the pathologicalty pes exist significant difference (P<0.05).