Objective: To study the qualitative diagnostic value of vessel convergence sign in ground glass nodules (GGNs) of lung in chest enhanced CT images. Methods: A retrospective analysis of 136 GGNs with 5-20 mm in diameter showed in dynamic enhanced CT image and confirmed by surgical pathology including 20 benign nodules, 32 pre-invasive lesions(PL), 31 minimally invasive adenocarcinoma(MIA) and 53 invasive adenocarcinoma(IAC) was performed. All patients were examined with dual-source CT for chest enhanced CT scan to observe and analyze the occurrence of GGN vessel convergence sign. Vessel convergence sign was classified into pulmonary artery abnormality (type Ⅰ) and pulmonary vein abnormality (type Ⅱ). Compared the occurrence of different types of vessel convergence sign in benign and malignant nodules. Results: Vessel convergence sign was found in 73 of the 136 GGNs (53.68%), the occurrence rate in benign GGNs(6/20, 30.00%) was significantly less than that in malignant GGNs (67/116, 57.76%) (P=0.021). For type Ⅰ vessel convergence sign, there was no significant difference between benign and malignant GGNs[10.00% (2/20) vs 13.79% (16/116), P=0.644], and between different pathological types of malignant GGNs [PL 12.50% (4/32), MIA25.81% (8/31), IAC7.55% (4/53), all P>0.05]. The occurrence rate of type Ⅱ vessel convergence sign in malignant GGNs (51/116, 43.97%) was significantly higher than that in benign GGNs(4/20, 20.00%) (P=0.044). With the increase in infiltration degree, the occurrence rate of type Ⅱ vessel convergence sign increased [PL21.88% (7/32), MIA25.81% (8/31)], IAC67.92% (36/53), P<0.001]. Significant differences in occurrence rate of type Ⅱ vessel convergence sign were found between IAC and MIA(P<0.001), as well as between PL and MIA (P<0.001), but not between PL and MIA (P=0.714). Conclusions: Vessel convergence sign showed potential value in the differentiation between benign and malignant GGNs. The presence of pulmonary vein vessel convergence sign in GGNs indicates the high risk of IAC.
CAO Qiqi, YANG Wenjie, YAN Fuhua, LIU Yan
. The qualitative diagnostic value of vessel convergence sign inground glass nodules of lung[J]. Journal of Diagnostics Concepts & Practice, 2018
, 17(05)
: 521
-525
.
DOI: 10.16150/j.1671-2870.2018.05.008
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