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目的探讨肺孤立性小结节HRCT分型。方法搜集经手术切除的肺内孤立小结节(直径≤20mm)39例(41个),术前均行螺旋CT和HRCT扫描。将孤立肺结节的HRCT表现分为2型:Ⅰ型,含磨玻璃密度结节(包括纯磨玻璃密度结节、低密度不均匀结节、中心高密度伴周边磨玻璃密度结节);Ⅱ型,单纯实性密度结节。并与病理对照。结果41个病灶的HRCT表现分型:Ⅰ型为14个病灶,其中肺泡癌9个、腺癌3个、炎性肉芽肿1个、腺瘤1个;Ⅱ型27个,其中腺癌13个、肺泡癌4个、鳞癌3个、小细胞癌1个、腺瘤2个、结核瘤2个、炎性肉芽肿1个、错构瘤1个。经统计学分析含磨玻璃密度的结节在手术切除的孤立肺结节中,肺泡癌组中高于非肺泡癌组(P=0.002),而在肿瘤与非肿瘤组、腺癌与非腺癌组差别无显著性(P=0.282和P=0.146)。结论根据手术切除的肺孤立结节HRCT表现,含磨玻璃密度结节多见于肺泡癌。
Objective To investigate the pulmonary solitary nodule HRCT classification. Methods Thirty-nine (41) isolated small nodules (diameter≤20 mm) in the lung were collected and scanned by helical CT and HRCT before operation. The HRCT findings of isolated pulmonary nodules were divided into two types: type Ⅰ, type Ⅰ with abrasive glass density nodules (including purely ground glass density nodules, low density non - uniform nodules, center high density with peripheral ground glass density nodules); Ⅱ type, simple solid density nodules. And pathological control. Results The HRCT features of 41 lesions were classified as type I with 14 lesions including 9 of alveolar carcinoma, 3 of adenocarcinoma, 1 of inflammatory granuloma and 1 of adenoma. There were 27 of type Ⅱ, including 13 of adenocarcinoma , 4 alveolar carcinoma, 3 squamous cell carcinoma, 1 small cell carcinoma, 2 adenoma, 2 tuberculoma, 1 inflammatory granuloma and 1 hamartoma. Statistical analysis of milled glass density of nodules in the surgical excision of isolated pulmonary nodules, alveolar carcinoma group was higher than non-alveolar carcinoma group (P = 0.002), while in the tumor and non-tumor group, adenocarcinoma and non-adenocarcinoma Group differences were not significant (P = 0.282 and P = 0.146). Conclusion According to the HRCT findings of isolated pulmonary nodules, there are more glassy density nodules in alveolar carcinoma.