| 基于胸部CT薄层扫描的肺磨玻璃病变浸润性风险值的研究 |
| 投稿时间：2024-12-06 修订日期：2024-12-27 点此下载全文 |
| 引用本文：苏雷,高艳,魏兵,张毅,刘宝东,王腾腾,李元博,钱坤,王雷明，魏秀芹.基于胸部CT薄层扫描的肺磨玻璃病变浸润性风险值的研究[J].医学研究杂志,2025,54(5):45-51 |
| DOI：
10.11969/j.issn.1673-548X.2025.05.010 |
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| 基金项目:“973”国家科技计划项目(2011CB510100) |
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| 中文摘要:目的 探索基于胸部CT薄层扫描(thin-section CT,TSCT)的肺磨玻璃病变(ground glass opacity, GGO)综合影像学特征的风险值,为临床医师预判GGO的浸润风险提供参考依据。方法 回顾性分析2020年1月～2023年12月于首都医科大学宣武医院胸外科接受胸腔镜手术治疗的3224例肺GGO病变患者的临床资料。GGO综合影像学特征的风险值为单一影像学特征包括形态和径度特征、边缘特征、内部特征、类型特征、CTR特征、观察时间和观察结果的动态特征的总和。结果 3224例患者包括男性987例(30.6%),女性2237例(69.4%)。GGO影像学最大径度平均为13.38±7.80mm。平均观察时间为13.49±21.07个月。术后病理报告中的91.1%(n=2936)为恶性病变,其中37.5%(n=1102)为腺体前驱病变,62.5%(n=1834)为浸润性病变。多因素Logistic回归分析结果显示,影像学特征中的GGO的最大径度、胸膜征、细支气管征、血管征、类型、CTR特征和风险值都是预判其为浸润性病变的独立影响因素。但ROC分析结果显示,与GGO的单一影像学特征比较,风险值的曲线下面积AUC为0.897(95%CI:0.886～0.909),cut-off值为25.5,其敏感度和特异性分别为82.6%和81.4%,对评估GGO为恶性浸润性病变具有更高的诊断价值。结论 基于TSCT的GGO综合影像学特征风险值有助于临床医生对GGO的浸润风险做出较为准确的预判。 |
| 中文关键词:肺磨玻璃病变 综合影像学特征 风险值 浸润性病变 |
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| A Study on the Infiltrate Risk of pulmonary Ground-Glass Opacities Based on Thin-Section CT Scans of the Chest |
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| Abstract:Objective To explore the risk value of comprehensive imaging features of lung ground glass opacity (GGO) based on thin-section CT (TSCT), and to provide a reference for clinical doctors in predicting the risk of GGO invasion. Methods A retrospective analysis was conducted on the clinical data of 3224 patients with pulmonary GGO lesions who underwent video-assisted thoracoscopic surgery at Xuanwu Hospital of Capital Medical University from January 2020 to December 2023. The risk value of GGO comprehensive imaging features was the sum of the dynamic features of a single imaging feature, including morphological and size, margin features, internal features, type features, CTR features, observation time and results. Results Out of 3224 patients, 987 (30.6%) were male and 2237 (69.4%) were female. The average maximum diameter of GGO was 13.38±7.80mm. The average observation time was 13.49±21.07 months. 91.1% (2936 cases) of postoperative pathological reports were malignant lesions,of which, 37.5% (1102 cases) were preinvasive lesions, and 62.5% (1834 cases) were infiltrative lesions. The results of multiple Logistic regression analysis show that the diameter, pleural sign, bronchiolar sign, vascular sign, GGO type, CTR feature and risk value of GGO were independent influencing factors for predicting it as an infiltrative lesion. However, the ROC analysis results showed that compared with the single imaging feature of GGO, the area under the curve of the risk value (AUC=0.897,95% CI:0.886-0.909), cut-off value was 25.5, with sensitivity 82.6% and specificity of 81.4%, had higher diagnostic value for evaluating GGO as infiltrative lesions. Conclusion The risk value of comprehensive features of GGO based on TSCT would help clinical doctors to make more accurate predictions about the infiltration risk of GGO. |
| keywords:Ground glass opacity Comprehensive imaging features Risk value Infiltrative lesion |
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