目的 探究肺部磨玻璃结节（GGN）高分辨CT征象与肺腺癌病理分型的关系。 方法 纳入2021年10月到2025年10月黄河三门峡医院接收的104例经病理证实的GGN患者进行研究。依据WHO肺腺癌病理分类标准，将患者分为浸润性腺癌（IAC）组、微浸润性腺癌（MIA）组、原位腺癌（AIS）组以及不典型腺瘤样增生（AAH）组。对比各病理分型患者的基线资料与临床指标、HRCT征象特征、HRCT定量参数；对比IAC各亚型（附壁型、腺泡型、乳头型）HRCT征象特征及定量参数；采用二元logistic回归分析探究IAC发生的影响因素；采用ROC曲线分析HRCT特征对IAC的诊断价值。 结果 IAC组分叶征占比、毛刺征占比、界面清楚毛糙占比、空泡征、支气管截断征、胸膜凹陷征、血管集束征占比显著高于MIA组、AIS组及AAH组（P < 0.05）。IAC组结节最大径、CT值、体积与质量均显著高于MIA组、AIS组及AAH组（P < 0.05），而相对CT值则显著低于其他3组（P < 0.05）。3组IAC各亚型HRC定性特征对比差异均无统计学意义（P > 0.05）。附壁型组CT值、体积、质量显著低于腺泡型组与乳头型组（P < 0.05），而相对CT值显著高于腺泡型组与乳头型组（P < 0.05），且腺泡型组CT值显著低于乳头型组（P < 0.05）。结节最大径、CT值、体积均为IAC发生的影响因素（P < 0.05）。分叶征、结节最大径、CT值、体积预测确诊IAC的AUC为0.668、0.929、0.827、0.909，联合预测AUC为0.992，敏感度97.01%、特异度75.68%，预测价值更高。 结论 肺部GGN高分辨CT征象与肺腺癌病理分型相关，其中IAC患者以结节最大径、CT值、体积偏大，且分叶征为著，且该类患者CT征象与非IAC存在明显差异；另外，CT定量参数与征象还能为临床鉴别IAC病理亚型分型提供参考。

Objective To explore the relationship between high-resolution CT signs of pulmonary ground glass nodules （GGN） and the pathological typing of lung adenocarcinoma. Methods A total of 104 patients with GGN confirmed by pathology from October 2021 to October 2025 were included in the study. Based on the World Health Organization （WHO） pathological classification criteria for lung adenocarcinoma， the patients were classified into the invasive adenocarcinoma （IAC） group， the minimally invasive adenocarcinoma （MIA） group， the adenocarcinoma in situ （AIS） group， and the atypical adenomatous hyperplasia （AAH） group. The baseline data， clinical indicators， high-resolution computed tomography （HRCT） sign features， and HRCT quantitative parameters of patients with different pathological types were compared. The HRCT sign features and quantitative parameters of IAC subtypes （wall-attached type， acinar type， and papillary type） were compared. Binary logistic regression analysis was employed to explore the influencing factors of IAC. The receiver operating characteristic （ROC） curve was utilized to analyze the diagnostic value of HRCT features for IAC. Results The proportions of lobulation sign， spiculation sign， clear and rough interfaces， vacuole sign， bronchial truncation sign， pleural indentation sign， and vessel convergence sign were significantly higher in the IAC group than those in the MIA， AIS， and AAH groups （P < 0.05）. The maximum nodule diameter， CT value， volume， and mass in the IAC group were significantly higher than those in the MIA， AIS， and AAH groups （P < 0.05）， whereas the relative CT value was significantly lower than that in the other three groups （P < 0.05）. There were no statistically significant differences in HRC qualitative features among the three IAC subtypes （P > 0.05）. The CT value， volume， and mass in the wall-attached type group were significantly lower than those in the acinar type and papillary type groups （P < 0.05）， while the relative CT value was significantly higher （P < 0.05）. Moreover， the CT value in the acinar type group was significantly lower than that in the papillary type group （P < 0.05）. The maximum nodule diameter， CT value， and volume were all influencing factors of IAC occurrence （P < 0.05）. The AUC values for predicting confirmed IAC using the lobulation sign， maximum nodule diameter， CT value， and volume were 0.668， 0.929， 0.827， and 0.909 respectively. Combined prediction yielded an AUC of 0.992， with a sensitivity of 97.01% and a specificity of 75.68%， indicating higher predictive value. Conclusions The high-resolution CT signs of pulmonary GGN are associated with the pathological typing of lung adenocarcinoma. In patients with IAC， the maximum nodule diameter， CT value， and volume are relatively large， and the lobulation sign is prominent. There are significant differences in CT signs between patients with IAC and those without IAC. Moreover， CT quantitative parameters and signs can also offer references for the clinical identification of IAC pathological subtypes.