PET／CT对肺部肿块的诊断  

The diagnostic value of PET/CT on solid pulmonary lesions

作　　者：王中秋[1] 吴江[2] 朱虹[2] 常林风[2] 陈英鑫[1] 卢光明[1] 

机构地区：[1]南京军区南京总医院医学影像科,210002 [2]南京军区南京总医院核医学科,210002

出　　处：《中华核医学杂志》2009年第1期19-22,共4页Chinese Journal of Nuclear Medicine

基　　金：国家重点基础研究发展计划（“973”计划）（2006CB705707）

摘　　要：目的探讨^18F-脱氧葡萄糖（FDG）PET／CT显像对肺部肿块的诊断和鉴别诊断价值，研究肿块大小和PET／CT显像最大标准摄取值（SUVmax）的相关性。方法对经病理检查和综合手段（临床、影像学或血液学等检查）证实的85例肺部肿块（59例恶性肿瘤、26例肺部良性肿块）患者进行回顾性分析。分别观察肺部肿块的CT形态（是否有脐凹、分叶、短细毛刺、粗盐样钙化、表面粗糙等）及PET显像肺部肿块感兴趣区（ROI）的FDG SUVmax。结合临床和病理诊断结果，分别比较分析PET、CT、PET／CT对肺部肿块诊断的灵敏度、特异性、准确性。对肿块大小和SUVmax进行Pearson相关分析。结果PET对85例肺部肿块患者诊断的灵敏度、特异性和准确性分别为89．8％（53／59）、61．5％（16／26）、81．2％（69／85）；CT分别为88．1％（52／59）、65．4％（17／26）、81．2％（69／85）；PET／CT分别为96．6％（57／59）、80．8％（21／26）、91．8％（78／85）。59例恶性肿瘤的肿块大小和SUVmax明显相关（r=0．617，P〈0．001），而26例肺部良性肿块大小和SUVmax不相关（r=0．211，P〉0．05）。结论”F-FDG PET／CT对肺部肿块较单纯PET、单纯CT的诊断灵敏度、特异性、准确性高；恶性肿瘤的肿块大小和SUVmax正相关，而良性病变的大小和SUVmax不相关。Objective The aim of this paper was to evaluate the diagnostic value of PET/CT with is F-fluorodeoxyglueose （FDG） for solid pulmonary lesions and the relationship between tumor size and max- imum standardized uptake value SUVmax of lesions. Methods A retrospective analysis was performed on 85 cases of patients with solid pulmonary lesions （59 malignant, 26 benign）. And 68/85 cases were confirmed pathologically by surgery or needle-biopsy and the other 17 cases by clinical follow-up after treatment. The shape, density, size of pulmonary lesions, and metastasis were surveyed based on CT findings. The SUVmax in region of interest （ROI） of pulmonary lesions were calculated on PET study. Imaging information were interpreted and compared with the histopathology findings or with clinical follow-up results. The sensitivity, specificity and accuracy of PET alone, CT alone and PET/CT scan were calculated. The tumor size on CT scan and SUVmax of lesions on PET scan were comparatively analyzed with Pearson correlation coefficient. Results In 85 cases of solid pulmonary Lesions, The sensitivity, specificity and accuracy of malignant pathology detection were respectively 89.8% （53/59）, 61.5% （ 16/26）, 81.2% （69/85） for PET alone; 88.1% （52/59）, 65.4% （ 17/26）, 81.2% （69/85） for CT alone, and 96.6% （57/59）, 80.8% （21/ 26） , 91.8% （78/85） for PET/CT scan. The tumor size of pulmonary malignant neoplasm in 59 patients correlated well with the SUV of the tumor （ r = 0. 617, P 〈 0. 001 ）. The size of pulmonary benign lesion in 26 patients did not have significant correlation with the SUVmax of the lesions （r = 0. 211, P 〉 0.05 ）. Conclusions PET/CT is of greater value in the differential diagnosis of solid pulmonary pathology than PET alone or CT alone. The sensitivity, specificity and accuracy are significantly improved by PET/CT scan. The lesion size is found positively correlated with SUVmax of tumor in malignant neoplasm, but not in benign lesions.

关 键 词：肺肿瘤 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R686[医药卫生—骨科学]