肺单纯磨玻璃影^(18)F-FDG PET/CT影像学特点及诊断价值  

Imaging features and clinical value of ^(18)F-FDG PET/CT for the diagnosis of lung pure ground glass opacity

作　　者：刘晓飞[1] 姚昊[1] 王志忠[1] 欧阳晓辉[1] 苏家贵[1] 何宝明[1] 

机构地区：[1]中国人民解放军第三0九医院核医学科,北京100091

出　　处：《医学影像学杂志》2013年第5期697-701,共5页Journal of Medical Imaging

摘　　要：目的探讨18F-FDG PET/CT诊断肺单纯性磨玻璃影(pGGO)的临床价值。方法收集36例肺pGGO患者的临床资料及18F-FDG PET/CT影像学资料,腺癌11例,支气管肺泡癌2例,腺癌并支气管肺泡癌2例,不典型腺瘤样增生3例,炎症3例,其他15例病灶经360天～720天随访无变化或消失诊断为良性病变;回顾性分析患者的性别构成、吸烟状况、病灶FDG代谢情况及形态学特点。结果①女性明显多于男性,非吸烟者明显多于吸烟者;②按病灶大小分为三组(<10mm组、10～15mm组、>15mm组),腺癌大小多为10～15mm组,不典型腺瘤样增生均小于15mm;③比较具有空泡征的恶性病灶与良性病灶,两者有显著差异(2=9.56,P<0.05),不典型腺瘤样增生多具有毛刺、分叶、空泡征;④根据病灶FDG摄取值(SUVmax)分为两组(≤0.5组、>0.5组),≤0.5组主要为不典型腺瘤样增生及其他良性病灶,>0.5组主要是恶性肿瘤,包括腺癌及细支气管肺泡癌;⑤本组15例肺癌,PET/CT正确诊断13例,准确性86.7%。结论 18F-FDG PET/CT能够有效诊断及鉴别诊断肺pGGO。Objective To investigate the characteristic PET/CT features in differentiation of pulmonary neoplastic diseases which appear as pure ground glass opacity. Methods Thirty six cases of neoplastic diseases （including 11 cases of adenocarcinomas, 2 cases of bronchioloalveolar carcinoma, 3 cases of inflammation, 3 cases of atypical adenomatous hyperpla- sia, and 15 cases of other benign lesions）, which appeared as focal ground glass opacity were collected, and the gender constitution, smoking status, FDG metabolism and morphologic characteristics of lesions, were analyzed. Results The numbers of females and non-smokers were significantly larger than those of males and smokers. All the lesions were classi- fied into two groups including ≤10 mm, 10-15 mm and 〉15 mm in size. In 10-15 mm group, the common nature of disease was adenocarcinomas, atypical adenomatous hyperplasia and bronchioloalveolar carcinoma, while in 〉15 mm group, the common diseases were atypical adenomatous hyperplasia. All the lesions with air bronchogram were classified into two groups including malignant lesions and benign lesions. There was asignificant difference in constituent ratio of different nature of lesion between two groups. All the SUVmax value of the lesions were classified into two groups including ≤0.5 and 〉 0.5. There was asignificant difference in constituent ratio of different nature of lesion between two groups. In ≤0.5 group, the common nature of disease was atypical adenomatous hyperplasia and other benign lesions, while in 0.5 group, the common diseases were malignant lesions including adenocarcinomas and bronchioloalveolar carcinoma. In 15 cases of lung cancer, only two cases were misdiagnosed as benign by PET/CT, with misdiagnosis rate of 13.3% and accuracy rate of 86.7%. Conclusion Air bronchogram is one of the most important signs of malignant lesions . SUVmax value plays an important role for the identification of pure ground glass opacity, high-resolutionCT combined with 18F- FDG-PET/CT scan play an importa

关 键 词：肺 单纯性磨玻璃影 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] R814.42[医药卫生—临床医学]