PET/CT与HRCT在孤立型细支气管肺泡癌诊断中的协同应用价值  

Synergistic Effect of PET/CT and HRCT in Diagnosing Solitary Bronchioloalveolar Carcinoma

作　　者：彭辽河[1] 丁久荣[1] 李杰[1] 邱大胜[1] 胡晓燕[1] 朱佳[1] 周静[1] 

机构地区：[1]湖北省肿瘤医院PET/CT中心,430079

出　　处：《临床放射学杂志》2012年第6期824-828,共5页Journal of Clinical Radiology

摘　　要：目的探讨正电子发射计算机体层成像(PET/CT)与高分辨率CT(HRCT)在孤立型细支气管肺泡癌(sol-itary bronchioloalveolar carcinoma,SBAC)诊断中协同应用的价值,以提高对该病的诊断准确率。方法搜集经手术病理证实的28例SBAC患者的PET/CT及HRCT影像资料,患者均先行PET/CT显像,其中16例根据诊断需要于0～3天内行HRCT检查,分析两者对SBAC的协同诊断价值。结果 28例中,PET/CT显像确切诊断肺癌者15例(53.6%),恶性不除外5例(17.9%),良性病变8例(28.6%),误诊率较高。16例HRCT协同PET/CT确切诊断肺癌15例,其中1例初诊良性病变,后经HRCT结合图像后处理技术诊断为肺癌,1例伴右肺门淋巴结转移者,HRCT图像仅显示形态正常淋巴结影,而PET/CT诊断淋巴结转移,后经病理证实;PET/CT与HRCT协同诊断正确率达100%。结论 PET/CT显像诊断SBAC易出现假阴性,误诊率较高;PET/CT与HRCT在SBAC诊断中的协同应用能够弥补常规PET/CT显像中的不足,达到优势互补并充分发挥PET/CT的资源优势,有助于提高对SBAC的诊断准确率。Objective To evaluate the synergistic effect of PET/CT and HRCT in diagnosing solitary bronchioloalveolar carcinoma （SBAC）. Methods The PET/CT images of 28 cases with pathologically confirmed SBAC were studied. Sixteen of the 28 cases were followed up after 0 - 3 days by HRCT study. The diagnostic accuracy rate and synergistic effect of PET/CT and HRCT were analyzed. Results According to PET/CT, there was definite diagnosis of malignant in 15 cases （53.6%）, no exclusion of malignancies in 5 cases （ 17.9% ）, definite diagnosis of benign tumors in 8 cases（28.6% ）. The misdiagnosis rate of PET/CT was high. According to PET/CT combined with HRCT, there was diagnosis of malignant tumors in 15 cases. One tumor diagnosed firstly as benign tumor by PET/CT, were definitely diagnosed as malignant by HRCT and three-dimensional images. In addition, one case of right hilar lymph node metastasis displayed on PET/CT showed normal on HRCT images, which was approved by pathology. Combined PET/CT and HRCT, 16 cases were diagnosed correctly. Conclusion The false negative rate and the misdiagnosis rate were high in the diagnosis of SBAC using routine PET/CT imaging. Combining PET/CT with HRCT was reasonable and practicable, which had synergistic effect in diagnosing SBAC and could greatly improve the diagnostic accuracy.

关 键 词：孤立型细支气管肺泡癌 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：R734.2[医药卫生—肿瘤]