| ?Purpose?To explore the relationship between imaging features and pathology of small pulmonary nodules less than 20 mm.?Materials and methods?Made retrospective analysis of 105 patients with lung lesions ?20mm from 2015 to 2017 in our hospital.There were 49 males and 56 females,whose average age were(54.4±10.97)and lesion size were 11.07 + 3.85 mm.The clinical and imaging data of all patients were complete.All lesions were received needle biopsy of lung under CT guidance.Sixty-nine of these patients went under surgery again,their pathological results were excision of the lesion.There were 23 males and 44 females,whose average age were(55.21±8.68)and lesion size were 10.25±3.68 mm.Analysis contents: 1.compared the 105 patients' imaging features with benign and malignant of biopsy;2.The comparison of imaging diagnosis,lung biopsy pathology and postoperative benign/malignant coincidence rates in 67 patients(2)The imaging features and pathological benign and malignant of the lesion of <10mm and 10 mm ~ 20 mm were analyzed.(3)Made imaging features analysis of preinvasive lesions and invasive lesions,preinvasive lesions and microinvasive lesions and the impact of needle biopsy of lung via CT-guided on distinguishing pathological types between two groups.Imaging analysis includes: position of the focus,size,CT value,performance of the lesion components(Pure grinding glass,mixed glass and solid nodules),the edge of the lesion(leaf,burr).The patients' age,CT value and lesion size were tested by rank sum test.The differences between gender,lesion distribution,lesion edge and pathological benign and malignant were analyzed by chi-square test or Fisher precise probability method.According to the ROC curve,the CT value and lesion size of the lesion were analyzed,and its specificity and sensitivity were discussed.?Results?1.Comparison between imaging and pathological results of 105 small pulmonary nodules: CT value of the lesion,composition of the lesion and lesion margins were statistically significant(p?0.05).2.67 patients who underwent surgical resection:(1)CT-guided percutaneous lung biopsy technique and imaging diagnosis are not significant differences in differentiating benign and malignant lesions(p?0.05).(2).Lesion components(pGGN/mGGN/solid nodules),lesion margins(burrs and lobes),and lesion CT values were statistically significant for pathological benign and malignant lesions of different sizes(less than 10 mm and 10 mm to 20 mm)(p?0.05).(3)Comparison of preinvasive lesion and invasive adenocarcinoma and preinvasive lesion and microinvasive adenocarcinoma(MIA)showed that: the difference between burr sign is statistically significant(p?0.05).The ROC curve was used to evaluate the significance and best critical value of the size and CT value of pulmonary nodules for the diagnosis of invasive adenocarcinoma and microinvasive adenocarcinoma.The area of invasive adenocarcinoma under the ROC curve was 0.878 and 0.916 respectively,and the critical value was CT-430.58 HU,and the size of lesion was 10.25 mm.The area of microinvasive adenocarcinoma under the ROC curve was 0.869 and 0.917 respectively,and the critical value was CT-429.64 HU,and the size of lesion was 11.75 mm.(4)Needle biopsy of lung under CT guidance technique was statistically significant to distinguish the difference between invasive adenocarcinoma,preinvasive lesion and microinvasive adenocarcinoma(MIA).?Conclusion?1?The CT values of the lesion's edge(the lobulated sign and burr sign),the components of the lesion(p GGN/mGGN/ solid nodules),and lesions have predictive value for distinguishing between benign and malignant nodules.2?Needle biopsy of lung under CT guidance had a great clinical effect on the pathologic diagnosis of pulmonary nodules.Conclusion about the relationship between the above imaging features and pathological types was helpful for the identification of pulmonary nodules. |
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