CT和正电子发射计算机体层摄影术诊断孤立性肺结节的局限性和协同作用  

The limitation and coordination of CT and positron emission tomography in the diagnosis of pulmonary nodules

作　　者：张金娥[1] 梁长虹[1] 赵振军[1] 王淑侠[1] 乔穗宪[1] 何晖[1] 张佳[1] 茹光腾[1] 

机构地区：[1]广东省人民医院医学影像部,广州510080

出　　处：《中华放射学杂志》2005年第11期1148-1152,共5页Chinese Journal of Radiology

摘　　要：目的分析CT和正电子发射计算机体层摄影术(PET)诊断孤立性肺结节(SPN)的局限性和二者的协同诊断作用.方法回顾性分析有病理证实的单个肺结节118例.所有病例CT和PET检查间隔时间<2周.病灶直径2～4 cm,平均2.7 cm.118例SPN中,恶性肿瘤87例,其中肺癌85例,结肠腺癌肺转移2例;良性31例,其中结核球8例,错构瘤6例,炎性假瘤6例,慢性非特异性炎症4例,炎性肉芽肿3例,隐球菌感染2例,脓肿和球形肺不张各1例.结果 118例SPN中,CT诊断正确93例,误诊25例,误诊率21.2%.其中12例肺癌误诊为良性,13例良性误诊为肺癌.PET诊断正确96例,误诊22例,误诊率18.6%.其中9例肺癌、1例结肠癌肺转移误诊为良性,12例良性误诊为恶性.CT和PET协同诊断,108例诊断正确,10例误诊,误诊率8.5% .CT、PET单独诊断和协同诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为86.2%、58.1%、85.2%、60.0%、78.8%;88.5%、61.3%、86.5%、65.5%、81.4%和97.7%、74.2%、91.4%、92.0%、91.5%.CT和PET单独诊断SPN的准确性无统计学意义(χ2＝0.625,P=0.239),协同诊断与CT、PET单独诊断SPN的准确性有统计学意义(χ2＝7.762和5.318,P=0.005和0.021).结论良、恶性SPN的CT和PET影像特征均有一定的重叠.单独采用CT或PET诊断肺结节的价值相当,CT和PET协同诊断的准确性高于CT或PET单独诊断.Objective To Analyze the limitation and coordination of CT and positron emission tomography （PET） in the diagnosis of pulmonary nodules. Methods A retrospective study was undertaken in 118 patients with pulmonary nodules which had CT and PET scan. The interval between examinations of various imaging equipment was less than 2 weeks. The diameter of nodules ranged from 2 cm to 4 cm with an average of 2. 7 cm. The nodules were proved as lung cancer by pathology in 85 cases and metastatic tumor in 2 cases, benign nodules in 31 cases, including 8 cases of tuberculosis, 6 cases of hamartoma, 6 cases of inflammatory pseudotumor, 4 cases of chronic nonspecific inflammation, 3 cases of inflammation granuloma, 2 cases of mycosis, 1 case of abscess, and 1 case of globular atelectasis. Results 93 cases were correctly diagnosed and 25 cases were misdiagnosed with CT in 118 cases of pulmonary nodules. The misdiagnosis rate of CT was 21.2%. 12 cases of lung cancer were misdiagnosed as benign and 13 cases of benign nodules were misdiagnosed as lung cancer. 96 cases were correctly diagnosed and 22 cases were misdiagnosed with PET. The misdiagnosis rate of PET was 18.6%. 10 cases of malignant nodules were misdiagnosed as benign and 12 cases of benign nodules were misdiagnosed as lung cancer. 108 cases were correctly diagnosed and 10 cases were misdiagnosed with CT coordinated with PET. The misdiagnosis rate was 8.5%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT, PET, and CT coordinated with PET were 86. 2% , 58. 1% , 85.2% , 60. 0% ,78.8% and 88.5% , 61.3% , 86. 5% , 65.5% , 81.4% , and 97.7%, 74.2% , 91.4% , 92. 0% , 91.5% respectively. The accuracy showed no significant difference between CT and PET （ X^2 = 0. 625, P = 0. 239） , but there were significant difference between CT coordinated with PET and CT or PET （ X^2 = 7.762 and 5. 318, P = O. 005 and 0. 021 ） . Conclusion The features of CT and PET in benign and malignant pulmonary nodules are partly overlapp

关 键 词：硬币病变 肺 体层摄影术 发射型计算机 X线计算机 

分 类 号：R816.4[医药卫生—放射医学]