基于CT GE Lung VCAR软件鉴别肺原位腺癌和微浸润腺癌

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摘要目的：利用GE Lung VCAR软件分析肺原位腺癌（AIS）与微浸润腺癌（MIA）的CT鉴别诊断要点。方法：收集2016年1月至2017年3月温州医科大学附属第一医院经病理证实的AIS患者50例、MIA患者55例。使用GE Lung VCAR软件对105例结节的CT图像进行三维后处理分析，比较2组结节实性成分及总体的左右径（LRD）、前后径（APD）、上下径（SID）、平均密度（DAVG）、非实性部分体积（VNS）、实性部分体积（VS）、总体体积（VT）、实性部分体积百分率（VS%）以及形态学特征的差异，并与二维轴位CT图像肺窗下手动测量结节最大径的诊断效能进行比较，评估GE Lung VCAR软件的诊断价值。结果：AIS组与MIA组的二维手动测量最大径与软件分析获得结节实性部分及总体三径、VS、VT、VS%、结节形态、毛刺征、结节与血管关系、累及血管根数的差异具有统计学意义（P＜0.05）。GE Lung VCAR软件评估结节大小较手动测量诊断效能高；部分参数诊断效能由高到低分别为：累及血管根数、毛刺征、总体LRD、实性APD、VT、VS；最佳截断值分别为：累及3根血管、短毛刺征、总体LRD：14.5 mm、实性APD：8.5 mm、VT：802 mm3、VS：133 mm3。结论：GE Lung VCAR软件在肺结节CT诊断中具有较好实用价值，是鉴别AIS和MIA的一项有利工具。

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	纪晓微
	傅钢泽
	李文斌
	杨运俊
	陈聪
	蔡蒙婷
	吴恩福

关键词 ：肺肿瘤, 原位腺癌, 微浸润腺癌, 体层摄影术, X线计算机

Abstract：Objective: The CT identification of lung adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) was analyzed by using GE Lung VCAR software. Methods: The CT images of 50 AIS patients and 55 MIA patients from the First Affiliated Hospital of Wenzhou Medical University were analyzed by GE Lung VCAR software after taking three-dimensional computed tomographic segmentation of lung nodules. The differences between AIS and MIA solid portion and their overall left-right diameter (LRD), anteroposterior diameter (APD), suprainferior diameter (SID), Average Density (DAVG), Non-Solid portion Volume (VNS), Solid portion Volume (VS), Total Volume (VT), percentage of Solid portion Volume (VS%), morphological features were compared. The diagnostic effectiveness of the two-dimensional manual measurements of nodule maximum diameter were compared to assess the diagnostic value of GE Lung VCAR software. Results: There’s statistical difference (P<0.05) between two-dimensional manual measurement of the maximum diameter and software analysis of the AIS group and the MIA group to obtain the solid nodule and the total three-segment, VS, VT, VS%, nodular morphology, burr sign, nodule-vessel relationship, number of vessel involvement. GE Lung VCAR software showed high diagnostic efficiency compared with manual measurement on nodule size. The diagnostic efficiency from high to low ranked as follows: involved vessel amount, spicule sign, overall LRD, solid APD, VT, VS. The optimal cutoff values were: three involved vessels, short spicule sign, overall LRD: 14.5 mm, solid APD: 8.5 mm, VT: 802 mm3, VS: 133 mm3. Conclusion: GE Lung VCAR software has practical value in the CT diagnosis of ground glass nodule. It is a useful supplement to identify AIS and MIA.

Key words： lung neoplasms adenocarcinoma in situ minimally invasive adenocarcinoma tomography, X-ray computer

收稿日期: 2017-09-29

基金资助:温州市公益性科技计划项目（Y20170222）。

通讯作者: 吴恩福，主任医师，Email：wzwef@163.com。

作者简介: 纪晓微（1990-），女，浙江温州人，住院医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I10/735

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