Clinical Study Of Hrct Diagnosis And Surgical Intervention Of Pure Ground-Glass Nodules

Objective:To analyze high-resolution CT(HRCT)features and change after follow-up of pulmonary nodules with pure ground-glass nodules(pGGNs)in order to acquire valuable imaging features for differential diagnosis between benign and malignant pGGNs,at the same time,select the appropriate timing of surgery for different types of pGGNs.Materials and methods:Clinical data,tumor size and density and HRCT findings in 66 cases(71 foci)of pGGNs confirmed by pathology were analyzed.Two samples T-test,χ~2 test were used to analyze the differences between different pathological types.Results:71 foci of pGGNs including 5 cases of benign,8 cases of AAH,15 cases of AIS,27 cases of MIA,11 case of IAC and 5 cases of lung adenocarcinoma(specific pathology not sure).Size and density of nodule,the presence of lobular,vascular cluster and pleural tag(p<0.05)were significant factors that differentiated preinvasive lesions and invasive adenocarcinoma of the lung.While,the presence of spiculated,bubble lucency,and air bronchogram were no statistical differences between preinvasive lesions and invasive adenocarcinoma of the lung.Before operation,30 cases of pGGNs were followed up,the mass of pGGNs(Maximum diameter or density)was increased in 9 cases(30%),and21cases(70%)was no change after the follow-up.Conclusion:Nodule size,density,the presence of lobular,vascular cluster and pleural tag were significant factors that differentiated preinvasive lesions and invasive adenocarcinoma of the lung.For the first time detected≥8.0<10.0 mm pGGNs,accompanied by the presence of lobular,vascular cluster and pleural tag,should follow-up HRCT closely,when the presence of a larger lesion or increased density in the subsequent follow-up may indicate the possible of malignancy.When the lesion≥10.0 mm,CT≥-650 HU,accompanied by the presence of lobular,vascular cluster and pleural tag,for the first time after the discovery of the standard anti-inflammatory treatment 7～10 days after drug withdrawal for 2 weeks,a total of 3 to 4 weeks recheck HRCT,if the lesion quality(maximum diameter or density)had no obvious absorption that is highly suggestive of malignant,it is commended biopsy or surgical resection.