^(18)F-FDG PET/CT结合HRCT在肺炎型细支气管肺泡癌诊断中的应用  

Application of 18F-FDG PET/CT combined with HRCT in diagnosing pneumonia type of bronchioloalveolar carcinoma

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

机构地区：[1]湖北省肿瘤医院PET/CT中心,湖北武汉430079

出　　处：《中国临床医学影像杂志》2012年第10期695-698,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨18F-FDG PET/CT结合高分辨率CT(HRCT)在肺炎型细支气管肺泡癌(PTBAC)诊断中的应用价值,以提高诊断准确率。资料与方法:搜集经病理证实26例PTBAC患者的18F-FDG PET/CT及HRCT影像资料,患者均先行18F-FDG PET/CT显像,其中15例根据诊断需要0~3 d内行HRCT检查,分析两者结合对PTBAC的诊断价值。结果:全组26例患者18F-FDG PET/CT显像检查,确切诊断肺癌9例,恶性不除外13例,肺感染性病变4例,确诊率为34.6%,误诊率较高;其中15例患者18F-FDG PET/CT显像后结合HRCT确切诊断肺癌13例,1例初次诊断感染性病变者后经结合HRCT图像诊断为肺癌,1例18F-FDG PET/CT显像及HRCT均疑为肺炎者,经18F-FDG PET/CT延迟显像后综合评判考虑肺癌,后病理证实;18F-FDG PET/CT结合HRCT诊断正确率达100%。结论:PTBAC的18F-FDG PET/CT显像特点及HRCT表现复杂多样,PET/CT结合HRCT在PTBAC诊断中的应用能够大大提高诊断准确率,减少误诊率。Objective： To evaluate the application value of ^18F-FDG PET/CT combined with HRCT in diagnosing pneumonia type of bronchioloalveolar carcinoma （PTBAC）. Materials and Methods： The ^18F-FDG PET/CT images of 26 cases with pathologically confirmed PTBAC were studied. Fifteen of the 26 cases were followed up after 0-3 days by HRCT study. The diagnostic accuracy rate of ^18F-FDG PET/CT combined with HRCT were analyzed. Results： According to ^18F-FDG PET/CT imaging, definite diagnosis of malignant was made in 9 cases, no exclusion of malignancies in 13 cases, and definite diagnosis of pulmonary inflammation in 4 cases. The diagnostic accuracy rate of ^18F-FDG PET/CT imaging was 34.6%. The misdiagnosis rate of ^18F-FDG PET/CT was higher. Associating ^18F-FDG PET/CT with HRCT, 13 of 15 cases were diagnosed as malignant tumors. Pulmonary inflammation was diagnosed firstly in 1 case by PET/CT, and then definite diagnosis of malignancy was confirmed by HRCT. In addition, the other one case of malignant tumor was analyzed as pulmonary inflammation by PET/CT and HRCT. However, ISF-FDG PET/CT displayed metastasis during the delay scanning, which was approved by pathology. Based on ^18F-FDG PET/CT and HRCT results, 15 cases were diagnosed correctly. Conclusion： PTBAC displays a variety of characteristics in lSF-FDG PET/CT and HRCT. Combining ^18F-FDG PET/CT with HRCT is reasonable and practicable for PTBAC diagnosis, which may be due to the synergistic effect on diagnosing PTBAC and can greatly improve the diagnostic accuracy.

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 螺旋计算机 

分 类 号：R734.2[医药卫生—肿瘤] R817.4[医药卫生—临床医学]