本文選題：肺腫瘤 + 腺癌��； 參考：《中國醫(yī)學影像學雜志》2015年06期

【摘要】：目的探討窗寬調整對表現(xiàn)為磨玻璃影的肺腺癌浸潤性的診斷作用,為正確診斷不同類型的肺腺癌提供指導。資料與方法回顧性分析肺窗表現(xiàn)為磨玻璃影且縱隔窗病灶不可見的浸潤前病變102例和浸潤性病變107例肺腺癌患者的術前CT資料,102例浸潤前病變中,不典型腺瘤樣增生25例,原位腺癌77例;107例浸潤性病變中,微浸潤腺癌78例,浸潤性腺癌29例。固定縱隔窗窗位(40 HU),調節(jié)窗寬值至病灶不可見,比較兩組不同病灶消失時的窗寬值,然后通過ROC曲線確定兩組病灶消失的窗寬值的最佳截斷點。結果浸潤前病變與浸潤性病變病灶消失的窗寬值不同(Z=-6.203,P0.05),窗寬值對于肺腺癌浸潤性的診斷價值較好(ROC曲線下面積0.748,P0.05),1303 HU為浸潤前病變和浸潤性病變病灶消失的最佳窗寬截斷點(敏感度為56.9%,特異度為86.0%)。結論窗口技術對于磨玻璃性肺腺癌浸潤性的診斷有一定的指導意義,當窗寬1303 HU時,病灶消失為浸潤前病變的可能性大;當窗寬1303 HU時,病灶消失為浸潤性病變的可能性大。
[Abstract]:Objective to investigate the role of window width adjustment in the diagnosis of invasive lung adenocarcinoma with glass grinding, and to provide guidance for the correct diagnosis of different types of lung adenocarcinoma. Materials and methods the preoperative CT findings of 102 cases of preinvasive lesions and 107 cases of invasive lesions of lung adenocarcinoma were retrospectively analyzed, including 25 cases of atypical adenomatous hyperplasia. Among the 77 cases of in situ adenocarcinoma, 78 cases were microinvasive adenocarcinoma and 29 cases were invasive adenocarcinoma. The window width of the mediastinal window was fixed at 40 HUU, and the window width was adjusted to be invisible. The window width of the two groups was compared when the lesions disappeared, and the best truncation point of the window width of the two groups was determined by the ROC curve. Results the window width of preinvasive lesions was different from that of infiltrative lesions. The value of window width in the diagnosis of invasive lung adenocarcinoma was better. The area under ROC curve was 0.748 and P0.05HU was the best window for preinvasive lesions and the disappearance of invasive lesions. Wide truncation (sensitivity 56.9, specificity 86.0). Conclusion window technique has a certain guiding significance in the diagnosis of invasive lesions in ground-glass adenocarcinoma of the lung. When the window width is 1303 Hu, the lesion is more likely to disappear into preinvasive lesions, and when the window width is 1303 Hu, it is more likely to disappear into invasive lesions.
【作者單位】： 同濟大學附屬上海市肺科醫(yī)院影像科;
【分類號】：R734.2;R730.44

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本文編號：1989221