Abstract: Objective To evaluate the diagnostic ability of the mean CT value for pulmonary ground glass nodules which were less than 1 cm. Methods We retrospectively evaluated 216 patients with ground glass nodules less than 1 cm between 2016 and 2020. All these ground glass nodules were resected and pathologically diagnosed. The mean CT value were measured in picture archiving and communication system（PACS） and its optimal cut-off point for the mean CT value was analyzed with receive operating characteristic（ROC） curve. Results The mean CT value of inflammatory lesion group was -782 ~ -377（-595.9±122.3） Hounsfield units（HU）, which was lower than lung adenocarcinoma group which the mean CT value was -807 ~ -57（-494.3±157.4）HU（t=-2.190,P<0.05）. The cut-off point was -604 HU, the sensitivity was 73.5% and the specificity was 67.3%, the area under curve（AUC） was 0.69. The mean CT value of the preinvasive group was -807 ~ -111（-540.1±131.1）HU, and The mean CT value of the invasive group was -807 ~ -57（-464.8±166.2）HU. The difference between the two group statistically significant （t=-2.66,P<0.05）. The cut-off point was -473 HU, the sensitivity was 50.8% and the specificity was 75%, the AUC was 0.64. Conclusion Themean CT value is valuable in the differential diagnosis of benign and malignant lesion in the ground glass nodules which was less than 1 cm, and it is helpful to judge the invasiveness of the lung adenocarcinoma.

Key words: lung ground glass nodules, tography, X-ray computer

摘要： 目的 探讨平均CT值测量对小于1 cm磨玻璃结节的诊断价值。方法 回顾性分析我院2016年1月至2020年1月经CT检查和手术切除的小于1cm的磨玻璃结节216例,利用医学影像存储和传输系统工作站,在薄层扫描肺窗图像上测量磨玻璃结节平均CT值,并通过ROC曲线确定最佳临界CT值。结果 炎性病变组平均CT值-782~-377（-595.9±122.3）HU低于肺腺癌组-807~-57（-494.3±157.4）HU（t=-2.190,P<0.05）,最佳临界值为-604 HU,敏感度、特意度分别为73.5%、67.3%,AUC值为0.69。浸润前病变组CT值-807~-111（-540.1±131.1）HU与浸润性病变组CT值-807~-57（-464.8±166.2）HU有统计学差异（t=-2.66,P<0.05）,最佳临界值-473 HU,敏感度、特意度分别为50.8%、75%,AUC值为0.64。结论 平均CT值测量在小于1 cm磨玻璃结节良恶性诊断中有一定的应用价值,并对判断肺腺癌是否浸润性具有一定的应用价值,为临床诊疗提供重要参考依据。

关键词: 肺磨玻璃结节, 体层摄影技术, X线计算机