| Objective: The imaging characteristics of Solitary Pulmonary Nodules were observed by256-slice spiral CT,and the key points of distinguishing benign and malignant solitary pulmonary nodules and their application value in predicting the aggressiveness of lung adenocarcinoma were discussed,so as to improve the detection rate of early lung cancer and provide imaging basis for clinicians to make reasonable follow-up and treatment plans.Methods: A total of 327 SPN patients who underwent 256-slice spiral CT chest scan in the First Affiliated Hospital of Jiamusi University from December 2017 to December 2020 were randomly selected.All cases were confirmed by postoperative pathology.(1)According to pathological results,they were divided into benign nodules group and malignant nodules group.Clinical data(including gender,age,smoking history,etc.)and imaging data of each group were observed.The latter focused on the diameter,location,solid or subsolid,air bronchial sign,vacuole sign,calcification,lobulation sign,burr sign,vascular cluster sign and pleural depression sign.(2)Eighty-seven patients with GGO on CT and pathologically confirmed lung adenocarcinoma were screened out.According to the degree of infiltration,they were divided into pre-infiltration group and infiltration group.Clinical data and imaging characteristics of each group were observed.The latter included: GGN diameter,location,density(p GGN or m GGN),vacuolar sign,lobulation sign,burr sign,tumor lung interface(clear/unclear),vascular cluster sign,pleural depression sign,and air bronchial sign.(3)Univariate analysis was used to compare the differences between groups.Chi-square test was used for qualitative data,and ANOVA was used for quantitative data.Multivariate Logistic regression analysis was conducted for the factors with statistically significant differences.P<0.05 was considered statistically significant.Results:(1)There were significant differences in gender,age,type of nodules,lobulation sign,air bronchial sign,vacuolar sign and vascular cluster sign between benign and malignant nodules groups(P<0.05).The indicators with statistically significant differences were included in multivariate Logistic regression analysis,and it was found that gender,age,nodular type and lobulation sign were independent risk factors for predicting benign and malignant pulmonary nodules.(2)There were significant differences in density(GGO),nodule diameter,tumor lung interface and vascular cluster sign between the two groups(P<0.05).Logistic regression analysis showed that nodule diameter and density(GGO)were independent risk factors for predicting the aggressiveness of lung adenocarcinoma.Conclusions: By observing and analyzing the imaging characteristics of SPN with 256-slice spiral CT,combined with the clinical data of the patients,the benign and malignant tendencies of SPN can be analyzed in detail,and the invasion of lung adenocarcinoma can be predicted accurately,so as to effectively guide the selection of clinical surgical methods and help the evaluation of the prognosis of SPN.In the differential diagnosis of benign and malignant SPN,the type of nodules,lobulation sign,vacuole sign,vascular cluster sign and air bronchial sign should be observed.In the study of predicting the aggressiveness of lung adenocarcinoma,the density(GGO)of the nodule,the diameter of the nodule,and the existence of clear tumor lung interface and vascular cluster sign should be observed,so as to provide a reliable diagnostic basis for the identification of early lung cancer and provide an accurate and optimized treatment plan for preoperative evaluation. |
