PET-CT及PET-CT结合Lung VCAR软件对非小细胞肺癌肺门区淋巴结的诊断分析  

Value of PET-CT and PET-CT combined with Lung VCAR software in the diagnosis of hilar area lymph nodes of non-small cell lung cancer

作　　者：于丽娟[1] 李迎辞[1] 王文志[1] 王欣[1] 陆佩欧[1] 田墨涵[1] 

机构地区：[1]哈尔滨医科大学附属第三医院PET-CT中心,150081

出　　处：《国际放射医学核医学杂志》2012年第6期323-328,共6页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：黑龙江省教育厅科学技术研究项目（12511326）

摘　　要：目的探讨PET—CT以及PET-C结合肺部容积式计算机辅助诊断（Lung VCAR）软件对肺门区淋巴结的诊断效能。方法49例术前行全身mF—FDGPET-CT检查高度怀疑非小细胞肺癌，并行病灶根治性手术及系统淋巴结清扫的患者资料纳入本研究，由两名PET—CT医师在不知病理结果的前提下，对肺门区淋巴结的PET-CT图像以及PET-CT结合LungVCAR软件得到的图像进行分析，然后再与病理结果进行对照。结果良、恶性淋巴结的CT值之间的差异无统计学意义（t=-1．40，P〉0．05），但良、恶性淋巴结的密度视觉分析、淋巴结短径和淋巴结最大标准化摄取值（SUVmax）对肺门区淋巴结良、恶性的判断之间的差异具有统计学意义坼=30．37、27．40、20．06，P均〈0．05）；以cT上淋巴结短径≥1cm、淋巴结密度等于或略低于同层血管密度和PET上淋巴结SUVmax≥2．5为判断标准，PET-CT对肺门区淋巴结诊断的灵敏度、特异度和准确率分别为76．5％、90．7％和88．3％，准确率明显高于单独的cT和单独的PET（g=15．27，P〈0．05）；结合Lung VCAR软件发现，PET-CT诊断出的103个肺门区淋巴结中，有4个不是肺门区淋巴结（3个为肺门区血管浓聚，1个为支气管软骨）。结论采用淋巴结视觉密度分析结合淋巴结直径和SUVmax的PET-CT分析方法，诊断非小细胞肺癌肺门区淋巴结的准确率较高；肺门区血管的浓聚是影响肺门区淋巴结辨别的主要原因，而LungVCAR软件有助于诊断。Objective To explore the diagnostic value of PET-CT and PET-CT combined with lung volume computed assisted reading（Lung VCAR）software in hilar area lymph nodes. Methods Preoperative whole body PET-CT imaging was performed in 49 patients who were highly suspicious of non-small cell lung cancer. PET-CT images of the hilar area lymph nodes and the PET-CT images of the hilar area lymph nodes from Lung VCAR software were evaluated by two experienced doctors, and then compared with the pathological diagnosis. Results There was no significant difference between the CT values of benign and malignant lymph nodes （t=-1.40, P〉0.05）. But a significant difference was existed between the benign and malignant hilar lymph nodes with the density visual analysis, the lymph short diameter and the maximum of standardized uptake value （SUVmax） 0（2=30.37, 27.40, 20.06, all P〈0.05 ）. The sensibility, specificity and accuracy of PET-CT in diagnosis of the hilar area lymph nodes were 76.5%. 90.7%, 88.3% respectively, and the accuracy of the diagnosis was significantly higher than that of CT and PET alone 0（2=15.27, P〈0.05 ） using the lymph short diameter≥ 1 cm of CT, the density of lymph node is equal to （slightly lower than） the same layer vascular density and the lymph node SUV~, i〉 2.5 of PET as the diagnostic criteria. One hundred and three hilar area lymph nodes were diagnosed by PET-CT and four nodes were not hilar lymph nodes proved by the Lung VCAR software （3 hilar vascular uptake, 1 bronchial cartilage）. Conclusion The methods of PET-CT lymph visual density analysis plus lymph node diameter and SUVmax had a high diagnostic accuracy of non-small cell lung hilar lymph. For the PET-CT, the pulmonary vascular uptake was the main cause affecting the discrimination of hilar lymph nodes, while Lung VCAR software was helpful to diagnosis.

关 键 词：癌 非小细胞肺 肺门淋巴结 正电子发射断层显像术 体层摄影术 x线计算机 LungVCAR软件 

分 类 号：R734.2[医药卫生—肿瘤]