^(11)C-胆碱PET-CT与电视纵隔镜在肺及中纵隔良恶性疾病诊断中价值的研究  

Role of PET-CT and videomediastinoscopy in diagnosis of diseases of lung and middle mediastinum

作　　者：彭忠民[1] 唐步坚[1] 刘奇[2] 刘庆伟[2] 姚树展[2] 孟龙[2] 陈景寒[2] 

机构地区：[1]广西医科大学,广西南宁530021 [2]山东省立医院胸外科,山东济南250021

出　　处：《中华肿瘤防治杂志》2006年第21期1648-1650,共3页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省优秀中青年科学家基金(2004BS03018)

摘　　要：目的:探讨正电子发射体层扫描及电视纵隔镜在中纵隔肿物(包括肿瘤及淋巴结)的诊断价值。方法:35例患者在4周内进行CT、11C-胆碱PET-CT及电视纵隔镜检查。应用11C-胆碱作为PET示踪剂,应用标准摄取值(SUV)作为PET检测指标,并与病理结果对照。结果:单纯纵隔病灶中,诊断为结节病的患者12例,结核5例,淋巴瘤7例,无典型“结节”的非干酪性肉芽肿3例。非小细胞肺癌或高度怀疑肺癌的患者8例中,有7例证实为纵隔淋巴结转移(N2或N3),1例纵隔淋巴结病理为反应性增生。根据良恶性分类,CT、11C-胆碱PET-CT及电视纵隔镜对纵隔肿物的诊断准确性分别为51.4%(18/35)、74.3%(26/35)及100%(35/35),电视纵隔镜优于11C-胆碱PET-CT(χ2=22.453,P=0.000)。恶性病灶的SUV值6.9(3.2～9.8,n=14)略高于良性病灶4.9(2.9～8.3,n=21),但差异无统计学意义,P=0.051。结论:电视纵隔镜对中纵隔疾病的诊断仍然是金标准,具有较高的准确性。11C-胆碱PET-CT对良恶性病灶的鉴别上有一定价值,单纯CT及单纯PET(SUV值)在一定程度上导致误诊。OBJECTIVE： To explore the value of positron emission tomography （PET） and videomediastinoscopy in the diagnosis of middle mediastinal masses which comprise a wide variety of tumors or lymphadenopathy. METHODS： Thirty-five patients were subjected to CT, PET-CT and videomediastionoscopy within four weeks. 11^C-cho line, as PET tracers, was used to visualize various masses. PET data were evaluated by using the standardized uptake value （SUV） and were analyzed in accordance with the pathologic data. RESULTS： There were 15 men and 20 women aged from 21 to 74 （mean 45.6）. Among the patients with mediastinal diseases, sarcoidosis was diagnosed in 12 patients, tuberculosis in 5 patients, lymphoma in 7 patients, and noncaseating granulomata without classical ＂sarcoid＂ in 3 patients. N2 or N3 nodal metastasis was revealed in 7 of 8 patients who had non-small cell lung cancer or suspected lung cancer, one was negative （the pathological diagnosis was reactive hyperplasia）. The accuracy of CT, PET-CT and videomediastinoscopy, if the diagnosis classified as benign or malignancy, was 51.4 % （18/35）, 74.3 % （26/35）, 100% （35/35）, respectively. The diagnostic accuracy of videomediastinoscopy was superior to that of PET-CT,χ^2= 22. 453,P= 0. 000. The SUV of malignancy lesion（6.9, 3.2 - 9.8; n = 14） was higher than that of benign lesion（4.9, 2.9-8. 3; n=21）, however, the difference was not statistically significant,P= 0. 051. CONCLUSION： To diag- nose lesions located in the middle mediastinumn, we confirm that videomediastinoscopy with a high diagnostic yield remains the gold standard. PET-CT is available for diagnosis of benign or malignancy lesion, however, CT alone or PET alone （SUV） may provide misdignosis in a certain proportion.

关 键 词：肺肿瘤/诊断 纵隔肿瘤/诊断 纵隔镜检查/方法 体层摄影术 发射型计算机 

分 类 号：R734[医药卫生—肿瘤]