CT Characteristics Of Pulmonary Multiple Ground Glass Nodules: Compared With Pathology

Objective To analyze CT features and histopathological findings of multiple groundglass nodules(GGN)in lung and to explore the diagnostic value of CT.Materials and Methods CT and pathological data of 106 patients with pathological proved multiple GGN were collected,including at least 2 GGN in each case.According to solid component within nodules,the nodules were divided into pure ground glass nodule(p GGN)and mixed ground glass nodule(m GGN).The position,the maximum diameter of nodule(Dmax)in axial images,shape,inside features(air bronchogram,vacuole sign,blood vessel),outside features(lobulation sign,speculation sign,chest depression)were analyzed respectively,and compared with pathological findings.Results 106 patients,28 males and 78 females,the age range of 38 to 75 years,mean age 59 ± 8 years,the gender difference was statistically significant,more common in women than men(P <0.05).Of the 106 patients,48 had lesions in the same lobe,37 had lesions in the ipsilateral lung but in different lobes,and 21 had lesions in the contralateral lung with no significant difference in distribution(P> 0.05).There were 241 lesions in 106 patients,106 in the right upper lobe,20 in the right middle lobe,48 in the right lower lobe,43 in the left upper lobe,and 24 in the lower lobe of the left lung There was statistical significance(P <0.05),lesions were more found in the upper lobe of the lung.Among 241 nodules,14 were atypical adenomatous hyperplasia(AAH),16 were adenocarcinoma in situ(AIS),77 were minimally invasive adenocarcinoma(MIA),110 were invasive pulmonary adenocarcinoma(IPA),and 19 chronic inflammatory,2 opportunistic pneumonia,1 granulomatous inflammation,1 fibrosis and 1 small cell lung cancer.There was no significant difference in the distribution of pathological types between the two groups(P> 0.05).The maximum diameter of nodule(Dmax)ranged from 4 to 13 mm with an average of 7.68 ± 2.94 mm in 19 cases of chronic inflammation,and the range of Dmax in 217 cases was 6 ~ 30 mm with an average of 16.41 ± 5.48,The difference was statistically significant(P <0.05),When Dmax> 10.50 mm,nodules are more likely to be neoplastic lesions.The difference between the two pathological types,lobulation sign,chest depression and vascular bundles sign was statistically significant(P <0.05),the above signs suggest that the lesion is the possibility of tumor lesions,speculation sign,air bronchogram and vacuole sign in the difference between the two was not statistically significant(P> 0.05).Between tumor-milled glass nodules,when the nodule diameter is> 8.50 mm,it is highly likely that the nodule is likely to be MIA or IPA,and vice versa is likely to be AAH or AIS.When the nodule diameter is>11.50 mm,suggesting that nodules are likely to be IPA.Between MIA and IPA,m GGN and irregularities were more common in IPA(P <0.05).There was also a statistically significant difference between the two groups in terms of lobulation sign,speculation sign,chest depression,air bronchogram,blood vessel(P <0.05).Further analysis found that when the above five signs appear more than two or two,suggesting that the possibility of nodules IPA large,on the contrary there 0 or 1 signs,MIA is more likely.Conclusion Observe the size,density and signs of multiple ground glass nodules in the lung can help determine the benign and malignant nodules and malignant nodules are invasive,and help guide the clinical development of a reasonable treatment.