晚期肺腺癌伴肺癌性淋巴管病^(18)F-FDGPET/CT的检查特征  

Imaging characteristics of Fluorine-18-fluorodeoxyglucose PET/CT examination in advanced lung adenocarcinoma with or without pulmonary lymphangiticcarcinomatosis

作　　者：孙晓琰 雷贝[1] 常城[1] 王利华[1] 刘柳 阮茂美 谢文晖[1] SUN Xiaoyan;LEI Bei;CHANG Cheng;WANG Lihua;LIU Liu;RUAN Maomei;XIE Wenhui(Department of Nuclear Medicine,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China)

机构地区：[1]上海交通大学附属胸科医院核医学科,上海200030

出　　处：《新疆医科大学学报》2018年第4期427-431,共5页Journal of Xinjiang Medical University

基　　金：上海市卫生和计划生育委员会课题(20174Y0077)

摘　　要：目的探讨晚期肺腺癌伴或不伴肺癌性淋巴管病(PLC)患者的PET/CT检查特征的差别。方法回顾性研究伴或不伴PLC的晚期肺腺癌88例,其中伴PLC的28例(PLC组),不伴PLC的60例(Non-PLC组)。患者均行全身PET/CT+屏气肺薄层CT扫描。测量肿瘤、肺各区淋巴结标准摄取最大值(SUVmax)、肿瘤代谢体积(MTV)、病灶糖酵解总量(TLG),测量肿瘤的最大直径等数据,对2组晚期肺腺癌患者各项数据进行统计分析。结果目视下PLC组病例均见小叶间隔增厚伴放射性摄取、支气管血管束增粗伴放射性摄取增强,同时见肺门及纵隔淋巴结肿大伴放射性摄取增强。临床病理资料中年龄、性别、肿瘤直径、原发肿瘤的代谢参数(SUVmax、MTV、TLG)在PLC组和Non-PLC组间未见差异。远处转移灶中,PLC组及Non-PLC组患者头颈腹盆淋巴结转移发生率存在差异(P<0.05)。对肺部淋巴结分区比较后,发现PLC组与Non-PLC组在1区、2R区、3A、5区淋巴结转移率有差异(P<0.05),PLC组在1区、2R区、3A、5区出现淋巴结转移的机率更高。PLC组与Non-PLC组比较,SUVmax仅在7区出现了差异(P<0.05),PLC组高于非PLC组。MTV、TLG值在1区、7区存在差异(P<0.05),PLC组高于Non-PLC组。结论晚期肺腺癌伴PLC患者PET/CT影像特点为PLC肺野处小叶间隔见放射性摄取、患侧支气管血管束放射性摄取增强、肺门及纵隔淋巴结肿大伴放射性浓聚。应用PET/CT参数与Non-PLC比较后发现其肺部转移淋巴结分布范围更广,1、7区转移性淋巴结肿瘤代谢体积更大、转移淋巴结肿瘤细胞代谢活性更强。Objective To explore the differences in the characteristics of PET/CT examination in patients with advanced lung adenocarcinoma with or without pulmonary lymphangitic carcinomatosis(PLC).Methods A Retrospective study of 88 cases of advanced lung adenocarcinoma with or without PLC,of which 28 cases(group PLC)with PLC,and 60 cases without PLC(group Non-PLC)was conducted.The patients had underwent PET/CT+thin breath holding CT scanning.The maximum standardized uptake value(SUVmax),metabolic tumor volume(MTV),the total lesion glycolysis(TLG)and the maximum diameter of tumor were measured and analyzed statistically.Results In the group PLC,thickening of interlobular septa with radiation uptake,thickening of bronchial vessels and enhancement of radioactivity,enlargement of hilar and mediastinal lymph nodes and enhancement of radioactivity were observed.There was no difference in terms of age,sex,tumor diameter,and metabolic parameters of primary tumor in the PLC and non-PLC.In the metastatic foci,there was a difference in the incidence of lymph node metastasis in the head and neck between the group PLC and the group non-PLC(P<0.01).And the rate of lymph node metastasis between the 2 groups existed difference in the area 1,2R,3A and 5,ie,the incidence of lymph node metastasis in the area 1,3A and 5 in group PLC was higher.The difference of SUVmax between the 2 groups was only in the area 7,and the SUVmax in the group PLC was higher than that in the group non-PLC.The values of MTV and TLG were different in the area 1 and 7,and that in group PLC was higher than that in group Non-PLC.Conclusion The PET/CT imaging features of advanced lung adenocarcinoma with PLC are PLC lobar septal radiosonde uptake,enhanced radiation uptake of bronchial vessels,hilar and mediastinal lymph node enlargement accompanied by radioactive concentration.The metastatic lymph nodes tumor in the area 1 and 7 have larger tumor metabolism volume and more metabolic activity of the tumor cells.

关 键 词：肺腺癌 肺癌性淋巴管病 PET/CT 

分 类 号：R445.5[医药卫生—影像医学与核医学]