PET/CT对981例肺结节的良恶性诊断价值分析  

Value of PET/CT in the diagnosis of benign and malignant pulmonary nodules:a report of 981 cases

作　　者：丁玲[1] 张伟华[1] 马靖[1] 余秉翔[1] 

机构地区：[1]解放军总医院健康管理研究院国际部,北京100853

出　　处：《癌症进展》2017年第3期277-279,共3页Oncology Progress

摘　　要：目的探讨健康体检PET/CT对恶性肺结节的诊断意义,通过^(18)F-脱氧葡萄糖(^(18)F-FDG)高代谢灶摄取度判定肺部恶性肿瘤的价值。方法回顾性分析981例肺结节患者的病例资料,包括良性肺结节966例,恶性肺结节15例。比较良恶性结节间病灶最大标准摄取值(SUVmax)之间的差异。结果 SUVmax≥2.5为PET/CT诊断恶性肿瘤的重要参考指标,PET/CT诊断灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为86.7%(13/15)、99.4%(960/966)、99.2%(973/981)、68.4%(13/19)、99.8%(960/962)。良性肺结节患者检查结果显示SUVmax为0~6.5,中位数为0.7,其中被误诊为恶性肺结节的患者分别是4例良性GGN经病理证实为坏死性肉芽肿(3例)/机化性肺炎(1例)、2例良性结节经病理证实为肺炎(1例)/纤维组织增生(1例);恶性肺结节患者检查结果显示SUVmax为0.8~16.3,中位数为4.7,其中恶性肺结节患者中2例肺泡癌患者漏诊。结论^(18)F-FDG PET/CT在筛查肺部结节良、恶性诊断中有重要意义,SUVmax对良、恶性程度的判断有指导意义。Objective To investigate the significance of physical examination by PET/CT in the diagnosis of malig- nant pulmonary nodules with high 18F-fluorodeoxyglucose （18F-FDG） uptake. Method 98l cases ofpuhnonary nodules, including 966 benign nodules and 15 malignant nodules, were analyzed. The average SUVmax of benign nodnles and ma- lignant nodnles was calculated. Result The SUVmax ≥2.5 in PET/CT was an important reference index for the diagno- sis of malignant tumors; for PET/CT, the diagnostic sensitivity, specificity, accuracy, positive predictive value and nega- tive predictive value were 86.7% （13/15）, 99.4% （960/966）, 99.2% （973/981）, 68.4%（13/19）, 99.85% （960/962）, respec- tively. Examination of patients with benign pulmonary nodules showed a SUVmax in 0-6.5, with a median of 0.7, in which 4 cases misdiagnosed as malignant pulmonary nodules were actually benign GGN pathologically confirmed as nec- rotizing granuloma （3 cases）/organizing pneumonia （l case）, while 2 cases of benign nodules were pathologically con- finned as pneumonia （1 case）/fibrous tissue hyperplasia （1 case）; patients with malignant nodules had SUVmax in 0.8- 16.3, with the median being 4.7, and 2 cases of pulmonary alveolar carcinoma were missed. Conclusion 18F-FDG PET/CT plays an important role in differentiating benign and malignant pulmonary nodules. The average SUVmax is directive in the diagnosis of malignant pulmonary nodules.

关 键 词：恶性肺结节 正电子发射断层成像 18F-脱氧葡萄糖 

分 类 号：R814.4[医药卫生—影像医学与核医学]