【摘要】 目的 探讨常规横断位与冠状位、矢状位多平面重建(multiplanar reconstruction, MPR)图像上肺纯磨玻璃结节(p GGN)圆度预测肺癌浸润性的诊断效能。方法 收集155例病人共168个p GGN的HRCT影像特征，经手术病理证实为肺腺癌，分为浸润前病变组[包括非典型腺瘤样增生(AAH)和原位腺癌(AIS))]和浸润性病变组[包括微浸润性腺癌(MIA)和浸润性腺癌(IAC)]。使用Photoshop(CS6)软件分别测量横断位与冠状位、矢状位MPR图像上p GGN圆度，两组间的组间差异采用独立样本t检验；利用二元logistic回归及ROC曲线评估横断位与冠状位、矢状位MPR图像圆度值在两组鉴别中的诊断效能。结果 浸润前和浸润性组在横断位、冠状位及矢状位MPR图像上圆度值分别为79.49%±4.86%和75.39%±7.51%、8 1.6 1%±5.0 3%和6 8.4 1%±1.0 6%、81.82%±4.26%和67.80%±1.06%，两组间差异均具有统计学意义(均P<0.05)。二元logistic回归显示冠状位及矢状位MPR图像圆度值对预测p GGN浸润性要(均P<0.05)优于横断位(P>0.05),OR值分别为0.067及0.039;ROC进一步显示矢状位MPR图像圆度值对预测p GGN浸润性优于冠状位，对应的AUC分别为0.922、0.892。结论 相对于常规横断位，冠状位和矢状位MPR图像上检测的圆度值对预测p GGN浸润性诊断效能更佳，其中矢状位重建图像诊断效能最佳。更多还原

【Abstract】 Objective Exploring the diagnostic efficacy of predicting lung cancer invasiveness based on the roundness of pGGN on multi planar reconstruction(MPR) images.Methods The HRCT features of 168 PGGNS confirmed by surgery and pathology were retrospectively analyzed in155 cases,which were divided into pre-invasive lesion group(including atypical adenomatous hyperplasia(AAH) and in situ adenocarcinoma(AIS)) and invasive lesion group(including microinvasive adenocarcinoma(MIA) and invasive adenocarcinoma(IAC)).The pGGN roundness in axial,coronal and sagittal MPR images was measured by Photoshop(CS6),The inter group differences were analyzed using independent sample t-test.Binary logistic regression and ROC curve were used to evaluate the diagnostic efficiency of MPR roundness in axial,coronal and sagittal sections.Results The roundness value of pGGN in axial,coronal and sagittal thin-slice CT sections in the pre-invasive and invasive lesion groups were 79.49%±4.86% and 75.39%±7.51%,81.61%±5.03% and 68.41%±1.06% 81.82%±4.26% and 67.80%±1.06%.The difference between the two groups was statistically significant(all P<0.05).By using binary logistic regression analysis,the roundness values of coronal and sagittal MPR images were found to be superior to those of axial images in predicting pGGN invasiveness(P<0.05),with OR values of 0.067 and0.039.ROC further showed that the roundness value of sagittal section was better than that of coronal section in predicting the invasiveness of pGGN,and the corresponding AUC were 0.922and 0.892,respectively.Conclusion Compared to axial images,the roundness values detected on coronal and sagittal MPR images have better diagnostic efficacy in predicting pGGN invasiveness,with sagittal images showing the best diagnostic effica cy.更多还原