Abstract:

Objective To investigate the correlations between multi-slice spiral CT (MSCT) atypical pleomorphic signs and pathological findings of lung metastases. Methods From January 2012 to July 2019, the MSCT chest imaging data of 168 metastatic tumor of lung from the General Hospital of Central Theater Command of the Chinese People's Liberation Army and Shaanxi Provincial Tumor Hospital were collected. According to the pathological type, they were divided into metastatic adenocarcinoma group (n=88) and metastatic squamous cell carcinoma group (n=80). The atypical imaging signs of MSCT of the two groups were observed and recorded, and classified after labeling one by one. The difference of atypical MSCT imaging features between the two groups was compared, and the correlations between lesion size and atypical imaging features of MSCT in the metastatic adenocarcinoma group and metastatic squamous cell carcinoma group were analyzed. Results The spicule sign in metastatic adenocarcinoma and metastatic squamous cell carcinoma were 61 (69.32%) and 28 (35.00%), with a statistically significant difference (χ²=19.811, P<0.001). The pleural depression sign in the two groups were 48 (54.55%) and 16 (20.00%), and there was a statistically significant difference (χ ²=21.206, P<0.001). The vacuole/cavity sign in the two groups were 10 (11.36%) and 61 (76.25%), and there was a statistically significant difference (χ ²=72.303, P<0.001). The air bronchial sign in the two groups were 43 (48.86%) and 13 (16.25%), with a statistically significant difference (χ ²=20.057, P<0.001). The halo sign/ground glass shadow in the two groups were 58 (65.91%) and 37 (46.25%), with a statistically significant difference (χ²=6.591, P=0.010). The results of the Spearman rank correlation analysis indicated a positive correlation between the size of metastatic adenocarcinoma and spicule sign, pleural depression sign (r=0.270, P=0.011; r=0.226, P=0.035). There was no correlation between the nodule size and atypical MSCT imaging features in metastatic squamous cell carcinoma (all P>0.05). Conclusion The atypical MSCT of metastatic lung adenocarcinoma are mostly spicule sign, pleural depression sign, air bronchial sign and halo sign/ground glass shadow. The characteristic atypical imaging of metastatic squamous cell carcinoma is vacuole/cavity sign. The spicule sign and pleural depression sign are related to the size of metastatic lung adenocarcinoma nodules.

Key words: Metastatic tumor of lung, Lung adenocarcinoma, Lung squamous cell carcinoma, Multi-slice spiral CT