Shuyi Yang1,2,3, Liang Yang4, Lin Teng2,3,5, Shan Zhang2,3, Yue Cui2,3, Yukun Cao2,3, Heshui Shi2,3. 1. Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China. 2. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. 3. Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China. 4. Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. 5. Department of Radiology, Henan Provincial People Hospital, Zhengzhou 450000, China.
Abstract
BACKGROUND: (I) To categorize and quantitatively analyze pleural signs on CT of pulmonary adenocarcinoma (≤3 cm); (II) to evaluate the association between pleural signs and visceral pleural invasion (VPI) of adenocarcinoma. METHODS: The clinical data of 52 pulmonary adenocarcinoma patients with 91 involved pleurae were retrospectively analyzed in one single institution. Pleural signs were categorized into five types of non-interlobar fissure pleura (group A) and four types of interlobar fissure pleura (group B). A new parameter called pleural indentation fraction (PIF) was firstly defined to quantitatively evaluate the level of pleural shift. RESULTS: In group A, type I pleural sign accounted for 15.79%, type II for 31.58%, type III for 21.05%, type IV for 10.53%, type V for 21.05%. The PIF of type II-III was 0.494±0.204. In group B, type I accounted for 67.65%, type II for 14.71%, type III for 8.82%, type IV for 8.82%. The PIF of type I was 0.188±0.083, significantly different with type II-III of group A (t=-7.444, P<0.001). The PIF of type I in group B had significant linear correlation with the tumor distance to the primary pleura. 41 patients with 75 involved pleurae formed the study part of pathological correlation with pleural signs. The rate of VPI was 87.5% (type III), 80% (type IV) in group A and 84.2% (type I), 40% (type II) in group B (t=30.895, P<0.001). The ratio of type III in group B was 2/2. Four cases with non-intact extrapleural fat layer were pathologically confirmed with VPI in type IV of group A. Six of seven cases with mediastinal pleural abnormality (type II-IV) were confirmed with VPI. CONCLUSIONS: Pleural signs can be categorized into five types of group A and four types of group B in the study. Type III-IV of group A and type I and III of group B may be indicators to VPI. Non-intact extrapleural fat layer and mediastinal pleural abnormality may increase the diagnosis accuracy of VPI.
BACKGROUND: (I) To categorize and quantitatively analyze pleural signs on CT of pulmonary adenocarcinoma (≤3 cm); (II) to evaluate the association between pleural signs and visceral pleural invasion (VPI) of adenocarcinoma. METHODS: The clinical data of 52 pulmonary adenocarcinoma patients with 91 involved pleurae were retrospectively analyzed in one single institution. Pleural signs were categorized into five types of non-interlobar fissure pleura (group A) and four types of interlobar fissure pleura (group B). A new parameter called pleural indentation fraction (PIF) was firstly defined to quantitatively evaluate the level of pleural shift. RESULTS: In group A, type I pleural sign accounted for 15.79%, type II for 31.58%, type III for 21.05%, type IV for 10.53%, type V for 21.05%. The PIF of type II-III was 0.494±0.204. In group B, type I accounted for 67.65%, type II for 14.71%, type III for 8.82%, type IV for 8.82%. The PIF of type I was 0.188±0.083, significantly different with type II-III of group A (t=-7.444, P<0.001). The PIF of type I in group B had significant linear correlation with the tumor distance to the primary pleura. 41 patients with 75 involved pleurae formed the study part of pathological correlation with pleural signs. The rate of VPI was 87.5% (type III), 80% (type IV) in group A and 84.2% (type I), 40% (type II) in group B (t=30.895, P<0.001). The ratio of type III in group B was 2/2. Four cases with non-intact extrapleural fat layer were pathologically confirmed with VPI in type IV of group A. Six of seven cases with mediastinal pleural abnormality (type II-IV) were confirmed with VPI. CONCLUSIONS: Pleural signs can be categorized into five types of group A and four types of group B in the study. Type III-IV of group A and type I and III of group B may be indicators to VPI. Non-intact extrapleural fat layer and mediastinal pleural abnormality may increase the diagnosis accuracy of VPI.
Authors: S Sone; F Sakai; S Takashima; T Honda; T Yamanda; K Kubo; K Fukasaku; Y Maruyama; F Li; M Hasegawa; A Ito; Z Yang Journal: J Thorac Imaging Date: 1997-07 Impact factor: 3.000