Preoperativeevaluationofvisceralpleuralinvasionoflungadenocarcinomawith MSCT
10.3969/j.issn.1002-1671.2019.04.009
- VernacularTitle:肺腺癌脏层胸膜侵犯的多层螺旋CT特征评估
- Author:
Xuehui PU
1
;
Mei YUAN
;
Tianyu CHEN
;
Hai XU
;
Wei ZHANG
;
Teng ZHANG
;
Jie CHEN
;
Tongfu YU
Author Information
1. 南京医科大学第一附属医院放射科 江苏 南京 210029
- Keywords:
pleuralinvasion;
lungcarcinoma;
lungadenocarcinoma;
computedtomography
- From:
Journal of Practical Radiology
2019;35(4):549-553
- CountryChina
- Language:Chinese
-
Abstract:
Objective Toimprovethepreoperativediagnosisoflungadenocarcinomaaccordingtotherelationshipbetweenthevisceralpleural invasion(VPI)andtheCTfeatures.Methods TheCTfeaturesandthepathologicalmanifestationsof351lungadenocarcinomasconfirmedby surgicalpathologywereretrospectivelyanalyzed.TworadiologistsindependentlyevaluatedtheCTfeatures,includingthelocationand maximumdiameterofthelesion,theminimumdistancefromthelesiontothepleura(DLP)inthree-dimensionalreconstructionimageandthe relationofthelesiontotheadjacentpleura(RAP).TheRAPwasdescribedas5types:(1)nocontactofthethelesionwiththepleura,(2)aline betweenthelesionandthepleurawithoutretractionoftheinvolvedpleura,(3)thelesiontightlyclosedtothepleurawithouttypical pleuraretraction,(4)oneormorelinearstrandsradiatedfromthelesiontothepleuralsurfacewithpleuralretraction,(5)broadcontactofthe lesionandpleurawiththecontactsurfaceoflesionover50% withpleuralretraction.Anexperiencedpathologistevaluatedthehistopathological patternsaccordingtothe7thEditionoftheTNMclassificationforlungcancer(PL0-PL2).AndthePL1andPL2weredescribed as VPI (+)group ,meanwhile the PL0 was as the VPI (-)group .Univariate analysis such as t test,χ 2 or One-W ay analysis of variance was performedtoidentifytheindependentpredictorsinpredictingVPI.Results Significantdifferenceswerefoundinpatientage,lesionlocation, maximumdiameter,andRAPbetweenVPI(+)andVPI(-)groups(P<0.05).Conclusion Whenthepatientwithlungadenocarcinomais over60yearsold,withthelesiondiameterover2.3cm,thepossibilityofvisceralpleuralinvasionwillbeconsideredaccordingtothe relationshipofthelesionandtheadjacentpleura(abuttingpleuralorpleuralindentation).
