^18F-FDGPET结合高分辨率CT在细支气管肺泡癌诊断中的价值  

The application of ^18FDG PET and HRCT in the diagnosis of bronchial alveolar carcinoma

作　　者：周敏 林关福[2] 陈文新[2] 

机构地区：[1]福建省莆田市第一医院核医学科,351100 [2]福建省立医院核医学科,福州350001

出　　处：《国际放射医学核医学杂志》2011年第6期347-350,共4页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨^18F．FDGPET及高分辨率CT（HRCT）在细支气管肺泡癌（BAC）诊断及鉴别诊断中的价值。方法回顾性分析具有完整临床资料的患者18例，其中病理检查确诊17例为BAC，1例经抗炎治疗后制土消失。测量病灶标准化摄取值（suv），分析病灶的影像学征象，比较单纯^18F-FDGPET、HRCT及二者联合诊断的效能。结果①单发结节组5例，SUV为1．5-3．5，其中4例同时行HRCT，见毛刺征4例、分叶3例、胸膜凹陷征3例、血管集束征3例、空泡征2例、毛玻璃征I例。②局限性实变组6例，SUV为1．6-2．3，其中5例同时行HRCT，见毛玻璃征5例、胸膜凹陷征3例、空泡征2例、支气管充气征2例、血管集束征1例。③混合组4例，SUV为4．5-10．0，4例均同时行HRCT，见毛玻璃征2例、空泡征1例、胸膜凹陷征2例、支气管充气征3例。④肿块组1例，SUV为5．6，见分叶、空洞、胸膜凹陷征及血管集束征。⑤多发结节组1例，SUV为4．6，见分叶、细毛刺征。，⑥假阳性组1例，病灶大小为2．1cm×2.3cm，SUV为1．2。结论单发结节组、局限性实变组的病灶对。8F-FDG摄取较低，易误诊，PET代谢显像结合HRCT有利于提高BAC诊断及答别诊断的准确率。Objective To investigate the features and diagnostic values of ISF-FDG PET and high resolution CT（HRCT） in patients with bronchial alveolar carcinoma（BAC）. Methods Seventeen cases with pathologically confirmed BAC and 1 case confirmed inflammation were studied retrospectively. The standardized uptake value（SUV） of the lesions were detected and ^18F-FDG uptake characteristics were studied. The diagnostic values of ^18F-FDGPET, HRCT and 18F-FDG PET combined with HRCT wereanalyzed. Results ① In the group of solitary nodule（n =5）, SUV of lesions were 1.5-3.5. HRCT（4/5） demonstrated spiculated（4/4）, lobulated（3/4）, pleural indentation（3/4）, vascular convergence（3/4）, vacuole sign（2/4） and ground-glass sign（1/4）. ②In the group of lobar consolidation（n=6）, SUV of lesions were 1.6-2.3. HRCT（5/6） demonstrated ground-glass（5/5）, pleural indentation（3/5）, vacuole sign（2/5）, air bronehogram sign （2/5） and blood vessel convergency（1/5）. ③In the group of mixed shadow（n=4）, SUV of lesions were 4.5- 10.0. Ground-glass sign, vacuole sign, pleural tag and air bronchogram sign were seen in 2,1, 2 and 3 cases respectively. ④There was 1 case in the group of mass lesion.The SUV of lesion was 5.6, and HRCT demonstrated lobulated, cavity, pleural indentation and blood vessel convergency. ⑤There was 1 case in the multi-nodular group, SUV was 4.6, lobulation and spiculation sign were found. ⑥SUV was 1.2 in the false positive case, with the lesion size of 2.1 cmx2.3 cm. Conclusions Low uptake of ^18F-FDG in solitary nodule and lobar consolidation groups might cause false negative in the diagnosis of BAC. To improve the diagnosisaceuracy and to decrease misdiagnosis rate of BAC, combination of HRCT with mF-FDG PET should be car- ried out.

关 键 词：腺癌 细支气管肺泡 氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 x线计算机 

分 类 号：R730.44[医药卫生—肿瘤]