关键词:

肺磨玻璃结节, 良恶性, 形态学, 电子计算机断层扫描, 纹理分析

Abstract:

Objective　To explore the diagnostic value of computerized tomography (CT) texture analysis and morphological features in benign and malignant pulmonary ground glass nodules. Methods　A retrospective study was conducted on the clinical data of 80 patients with pulmonary ground glass nodules admitted to Yan'an University Xianyang Hospital from January 2021 to January 2023. All the patients received surgical resection and pathological findings were obtained, according to the pathological findings, all patients were divided into a benign group (34 cases) and a malignant group (46 cases). In the benign group, there were 20 males and 14 females, aged 35-83 (58.32±11.25) years. In the malignant group, there were 26 males and 20 females, aged 34-85 (58.93±12.48) years. Preoperative CT image data of all the patients were collected, and the CT texture parameters and morphological characteristics of pulmonary nodules in the two groups were compared and analyzed. The receiver operating characteristic curve (ROC) was drawn, and the area under the curve (AUC) was calculated to analyze the diagnostic efficacy of CT texture parameters and morphological characteristics in the diagnosis of benign and malignant pulmonary ground glass nodules. The statistical methods used were t test, H test, and χ² test. Results　The mean sum, entropy, entropy sum, and entropy difference of the benign group were lower than those of the malignant group (63.93±5.32 vs. 68.93±12.36, 1.53±0.28 vs. 1.94±0.37, 1.03±0.22 vs. 1.33±0.58, 0.90±0.08 vs. 1.23±0.11), with statistically significant differences (t=2.209, 5.413, 2.863, and 14.823, all P<0.05). The long diameter, short diameter, volume, solid partial space, average CT value, lobular sign, burr sign, vacuolar sign, air bronchial sign, pleural depression, vascular bunching, and bronchial truncation in the malignant group were higher than those in the benign group, with statistically significant differences (all P<0.05). Multivariate logistic regression analysis showed that the mean sum, entropy, entropy sum, and entropy difference had statistical significance in the detection of benign and malignant pulmonary ground glass nodules (all P<0.05). According to ROC analysis, the AUC for benign and malignant pulmonary ground glass nodules were 0.757, 0.690, 0.734, and 0.763, the specificities were 88.24%, 79.38%, 67.29%, and 76.37%, and the sensitivities were 58.25%, 59.34%, 68.27%, and 79.36%; CT texture combined with morphological features had higher specificity and sensitivity for the diagnosis of benign and malignant pulmonary ground glass nodules, which were 81.34% and 95.68%, respectively. Conclusion　CT texture and morphological features are of great value in the differential diagnosis of benign and malignant pulmonary ground glass nodules, and can provide certain guidance and reference for the formulation of precancerous lesions and clinical treatment of pulmonary ground glass nodules.

Key words:

Pulmonary ground glass nodules, Benign and malignant, Morphology, Computed tomography, Texture analysis