Multi-slice spiral CT study of the relationships between pulmonary ground glass nodules and bronchi

Abstract

Objective To investigate the relationships and types between pulmonary ground glass nodules (GGN) and bronchi and explore its value in diagnosis. Methods One hundred and twenty-seven GGN lesions were reviewed after (include 68 lesions of pulmonary adenocarcinoma,15 lesions were preinvasive lesions and 44 benign lesions) with MSCT.It was observed that lesion distribution,content of solid components and relationships between GGNs and bronchi both in axial images and multi-planar reformation (MPR) images.The lesions were divided to three types according to the ratio of ground glass opacity.Type A was pure GGN.Type B was mixed GGN which contain 76% to 99% of ground glass opacity content.Type C was mixed GGN which contain 50% to 75% ground glass opacity content.The relationships between GGN and bronchi were divided into five types.Type I: The bronchi were“cutoff”in the solid part of GGN.TypeⅡ: The bronchi were distortion and extension in the solid parts of GGN.TypeⅢ: The bronchi were distortion and extension in the GGO parts of GGN.TypeⅣ:The bronchi were normal course in the GGO parts of GGN.TypeⅤ: The bronchi were circumvent GGN lesions.SPSS16.0 software was used for statistical analysis,measurement data using independent t test,measurement data using Pearsonχ2test; when there was a theory number<1 or income probability close to test level,then using Fisher's exact test,Spearman rank correlation were used for analyze the content of ground glass in GGN and its relationship with the bronchial type.It was considered to be statistically significant whenPvalue less than 0.05. Results (1) There was no significant statistic significance about lesion's location among 3 groups.The P value of group of invasive adenocarcinoma,preinvasive group and benign group were 1.000,1.000,0.817 respectively. (2) The incidence of having relationships between GGN and bronchi were significant statistic significance among 3 groups (χ2=36.32,P<0.01). (3) There were 14 cases of group of invasive adenocarcinoma,0 case of preinvasive group,0 case of benign group when the relationship between GGN and bronchi were typeⅠ.There were 25 cases of group of invasive adenocarcinoma,0 case of preinvasive group,3 cases of benign group when the relationship between GGN and bronchi were typeⅡ.There were 10 cases of group of invasive adenocarcinoma,0 case of preinvasive group,2 case of benign group when the relationship between GGN and bronchi were typeⅢ.There were 8 cases of group of invasive adenocarcinoma,1 case of preinvasive group,12 cases of benign group when the relationship between GGN and bronchi were typeⅣ.There was 1 case of group of invasive adenocarcinoma,0 case of preinvasive group,9 case of benign group when the relationship between GGN and bronchi were typeⅤ.There was significant statistic significance among 3 groups of relationships between GGN bronchi (P<0.01).The relationships between GGN and bronchi of adenocarcinomas most manifest as type I and typeⅡ.There were no relationships with bronchi of most preinvasive lesions.The relationships between GGN and bronchi of benign lesions most manifest as typeⅣand typeⅤ. (4) It was divided into 3 categories according to different proportion of solid components in CT images.There were 17,19 and 49 cases in Category A,B,C respectively,and the difference of GGO percentage among different categories with the relationships between GGN and bronchi were correlation statistic significance (r=-0.546,P<0.01). Conclusions There were different manifestations of relationships between GGN and bronchi in different kind of lesions.It may help to differential diagnosis through comprehensive evaluate the content of GGO area of lesions. Key words: Bronchi; Multiple pulmonary nodules; Tomography,X-ray computed