The value of CT features and quantitative analysis of contrast-enhanced CT scan in predicting the invasion of pulmo-nary ground-glass nodules

WANG Qian; PENG Wenting; WANG Rong; XIE Bingkun

Abstract：Objective To investigate the value of CT features and contrast-enhanced quantitative analysis in predicting the invasion and degree of invasiveness of ground glass nodules(GGNs).Methods Clinical data and CT images of 102 patients(114 lesions)whose manifestations were GGNs verified by surgery and pathology were retrospectively analyzed.and all patients underwent enhanced CT scanning.According to the pathological type,they were divided into three groups:precursor gland le-sions(atypical adenomatous hyperplasia AAH+adenocarcinoma in situ AIS),micro-invasive adenocarcinoma(MIA)and inva-sive adenocarcinoma(IAC).The quantitative and qualitative data of the nodules were compared,and subject operating character-istic(ROC)curve analysis was performed for each parameter.Binary logistic regression analysis was used to evaluate the inde-pendent risk factors of the degree of nodular invasion.Results There were statistically significant differences among the three groups in the size,shape,nodule type,bronchial abnormal sign,internal vascular sign,pleural traction sign.There was no sig-nificant difference in sex,smoking history and tumor-lung interface among the three groups(P=0.432,0.405,0.205).All CT quantitative indexes(unenhanced CT value,CT values on enhancement in arterial phase,CT values on enhancement in venous phase,arterial phase enhancement difference,venous phase enhancement difference,arterial phase enhancement index,and venous phase enhancement index)were significantly different among the three groups(P<0.001).Except that the unenhanced CT value was not statistically significant between AAH+AIS and MIA groups(P=0.075),the ROC curve analysis showed that unen-hanced CT value,CT values on enhancement,degree of enhancement and enhancement index had the highest diagnostic effi-ciency.Binary logistic regression analysis showed that nodule type(OR=47.143,95%CI 2.549～871.918,P=0.010)and inter-nal vascular sign(OR=11.466,95%CI 1.209～108.713,P=0.034)were independent risk factors for degree of invasiveness of GGN.Conclusion CT features and quantitative analysis of contrast-enhanced CT scan have high diagnostic and predictive value for the invasive of pulmonary ground-glass nodules,nodule type and internal vascular sign are independent risk factors for degree of invasiveness of GGN.