^(18)F-FDG符合线路SPECT/CT显像在胸腔肿瘤诊断中的应用  

The role of ^(18)F-FDG coincidence SPECT/CT in evaluation of the tumors of thoracic cavity

作　　者：李多[1] 张卫红[1] 李亚威[1] 王萌[1] 吕平欣[1] LI Duo;ZHANG Wenhong;LI Yawei;FANG Meng;LYU Pingxin(Imaging Center,Beijing Chest Hospital Affiliated to Capital Mechial University,Beijing 101149,P.R.China)

机构地区：[1]首都医科大学附属北京胸科医院影像中心,北京101149

出　　处：《医学影像学杂志》2018年第8期1303-1307,共5页Journal of Medical Imaging

摘　　要：目的探讨18F-FDG符合线路SPECT/CT显像在胸腔肿瘤诊断中的价值。方法 2013年1月~2016年11月期间病理确诊的14例胸腔肿瘤,回顾性分析患者治疗前的18F-FDG符合线路及CT图像。记录病灶的病理类型、CT征象、符合线路图像病灶目测分级和病灶放射性摄取值与纵隔及肺本底的比值(T/M和T/L)。结果 8例神经源性肿瘤(神经纤维瘤2例,良性神经鞘瘤5例,恶性外周神经鞘瘤1例),6例间叶组织肿瘤(良性孤立性纤维瘤3例,恶性孤立性纤维瘤2例,恶性纤维组织细胞瘤1例)。按照良恶性分组为良性组10例和恶性组4例。良性组与恶性组平均年龄及CT征象均无统计学差异。恶性组T/L及T/M明显高于良性组,并且有统计学差异(13. 31 vs 4. 91,P=0. 036;3. 12 vs1. 13,P=0. 002)。以目测分级高于纵隔诊断为恶性病变的准确率为85. 7%,敏感性100%,特异性80. 0%,2例假阳性病例均为神经源性肿瘤(神经鞘瘤和神经纤维瘤各1例)。神经源性肿瘤与间叶组织肿瘤CT表现及符合线路显像特征均无显著差异。结论 SPECT/CT符合线路显像鉴别胸腔肿瘤良恶性的准确率高,并且鉴别间叶组织肿瘤的良恶性准确率较神经源性肿瘤高,具有简便直观的优势,有利于为患者制定合理的治疗计划。Objective To investigate the value of ^18F-FDG coincidence SPECT/CT imaging in the diagnosis of thoracic cavity tumors. Methods Fourteen patients with pathologically confirmed thoracic cavity tumors were retrospectively analyzed. The18 FFDG coincidence SPECT/CT and CT images were analyzed retrospectively. The pathological types,CT features,visual degree of radioactive uptake of the lesion and the ratio of the lesion to the mediastinum and the lung（T/M and T/L） were recorded. Results There were eight neurogenic tumors（2 neurofibroma,5 benign schwannoma and one malignant peripheral nerve sheath tumor） and six mesenchymal tumors（3 benign solitary fibrous tumors,2 malignant solitary fibrous tumors and 1 malignant fibrous histiocytoma）. There were 10 benign lesions and 4 malignant lesions. There was no significant difference between benign group and malignant group in mean age and CT findings. T/L and T/M was significantly higher in malignant group than benign group（13. 31 vs 4. 91,P = 0. 036; 3. 12 vs 1. 13,P = 0. 002）. By visual rating,the radioactivity was higher than mediastinal to diagnosis for malignant lesions. Accuracy was 85. 7% for take visual grade higher than mediastinum as the cut-off to differentiate malignant and benign thoracic cavity tumor,with 100% of sensitivity and 80% of specificity. Two false positive cases were one shewomoma and one neurofibroma. There was no significant difference between neurogenic tumors and the mesenchymal tumors considering the CT manifestations and coincidence imaging characteristics. Conclusion SPECT/CT coincidence imaging cannot differentiate between neurogenic tumors and pleural mesenchymal tumors. Visual grade higher than mediastinum could be an easy and useful way to predict malignant thoracic tumors.

关 键 词：神经源性肿瘤 间叶组织肿瘤 体层摄影术 X线计算机 氟代脱氧葡萄糖 符合线路SPECT 

分 类 号：R561[医药卫生—呼吸系统] R814.42[医药卫生—内科学]