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Objective:To explore the predictive value of qualitative and quantitative parameters of dual-layer spectral detector CT plain scan on the invasiveness of pure ground-glass pulmonary nodules (pGGNs).Methods:Clinical and imaging data of 113 patients (119 pGGNs) with pathology-proven lung adenocarcinoma who underwent preoperative dual-layer spectral detector CT plain scan in Tianjin Medical University Cancer Institute and Hospital from November 2019 to December 2020 were retrospectively analyzed. According to invasiveness, pGGNs were divided into non-invasive adenocarcinoma (non-IA) group ( n=66) and IA group ( n=53). The non-IA group included atypical adenomatous hyperplasia ( n=10), adenocarcinoma in situ ( n=26) and minimally invasive adenocarcinoma ( n=30). The qualitative parameters were nodule shape, lung-tumor interface, lobulation, spiculation, pleural retraction, bubblelike lucency, air bronchogram and vascular abnormality. The quantitative parameters included nodule size, effective atomic number (Z eff), CT value on 120 kVp images (CT 120 kVp) and virtual monoenergetic images from 40 keV to 200 keV (CT 40 keV-CT 200 keV), and slope of energy spectrum curve (λHU). The χ 2 test, Mann-Whitney U test and independent sample t test were used to analyze the parameter differences between non-IA group and IA group. Multivariate logistic regression analysis was performed to screen out independent predictors. Receiver operating characteristic (ROC) curve was used to assess the diagnostic efficacy of single predictor and combined independent factors for the invasiveness of pGGN. Results:Significant differences were found in nodule shape, lobulation, air bronchogram, vascular abnormality, nodules size, Z eff, CT 120 kVp and CT 40 keV-CT 200 keV between non-IA and IA groups ( P<0.05). The maltivariate logistic regression analysis showed that nodule size [odds ratio 9.269, 95% confidence interval (CI) 1.640-52.395, P=0.012] CT 200 keV (odds ratio 1.012, 95%CI 1.006-1.019, P<0.001) as well as vascular abnormality sign (odds ratio 4.940, 95%CI 1.358-17.969, P=0.015) were independent predictors of pGGN invasiveness. ROC curve analysis of a single independent predictor and a combination of the three factors showed that the area under the curve (AUC) of the combination of three factors predicting the invasiveness of pGGN was significantly higher than the AUC of vascular abnormality sign ( Z=4.01, P<0.001) and CT 200 keV ( Z=3.25, P=0.001), while there was no significant difference in AUC between the combination of the three factors and nodule size ( Z=1.94, P=0.052). The AUC of the combination of the three independent predictors was 0.909, and the sensitivity and specificity for predicting pGGN invasion were 81.1% and 86.4%, respectively, using a threshold of 0.505. Conclusion:The combination of qualitative and quantitative parameters of dual-layer spectral detector CT plain scan shows a high predictive value for the invasiveness of pGGNs.
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Objective To investigate the risk factors for osteoporosis (OP) in aged people at Beicai Town in Shanghai, to provide proofs for preventing OP. Methods Questionnaire survey was carried out on bone density in 608 aged people (aged from 60 to 79 years) who were randomly chosen from 4 resident committees of Beicai Town in Shanghai. Everyone underwent bone mineral density (BMD) assay of lumbar spine and total hip by DEXA machine. Results The rate of OP was 23 % in male group, and 61% in female group. It was 40% in 60-64 years old group, 44% in 65-69 years old group, 53% in 70-74 years old group and 66% in 75-79 years old group. The rate of OP was 52% in manual work group, and 42 % in non-manual work group. In males, it was 54 % in current weight less than 60 kg group, 19% in 60-70 kg group, 15% in 70-80 kg group and 23% in over 80 kg group. In females, it was 76% in current weight less than 50 kg group, 67% in 50-60 kg group, 63% in 60-70kg group, 30% in over 70 kg group. It was 56% in low body weight group, 41% in normal weight group and 58% in over weight group in their 25-year-old. It was 61% in normal body weight group, 43% in overweight group. It was 41% in non-fracture history group, 67% in once fracture group,74% in fracture history more than twice group. It was 60% in mother humpback history group, and 47% in no history of mother humpback group. Logistic regression analysis showed that gender, age,history of fracture, mother's humpbacked history, disease of internal secretion and metabolism system were the risk factors for OP. Conclusions The occurrence of OP is related with many factors in aged people at Beicai Town in Shanghai, especially for the aged women, who suffer from diseases of internal secretion and metabolism, and has the history of fracture and mother's humpbacked, the attention should be payed to the prevention and treatment of OP.