^(18)F-FDG PET/CT在偶发性孤立性肺结节诊断中的应用价值  

The value of ^(18)F-FDG PET/CT imaging in the diagnosis of incidental solitary pulmonary nodules

作　　者：刘晓飞[1] 苏家贵[1] 周晓红 张婷[1] 王志忠[1] 何宝明[1] LIU Xiaofei;SU Jiagui;ZHOU Xiaohong;ZHANG Ting;WANG Zhizhong;HE Baoming(Department of Nuclear Medicine,The People's Liberation Army 309 Hospital,Beijing 100091,P.R.China)

机构地区：[1]中国人民解放军第三〇九医院核医学科,北京100091

出　　处：《医学影像学杂志》2018年第4期599-602,共4页Journal of Medical Imaging

基　　金：中国人民解放军第三〇九医院科研基金面上项目(编号:2015MS-015)

摘　　要：目的探讨偶发性孤立性肺结节(SPN)的临床及^(18)F-FDG PET/CT影像学特征。方法回顾性分析2009年7月~2016年7月间的CT扫描偶然发现的106例SPN病例,汇总其性别、年龄、实验室检查及影像学检查等资料。结果在106例患者中,71例确诊为肺癌,35例为良性病变,男44例,女62例,平均年龄(57.5±17.1)岁,结节最大标准化摄取值(3.62±3.50)(SUVmax值),均经病理学诊断或者随访3年以上;^(18)F-FDG PET/CT检查的灵敏度、特异性、准确性分别为91.6%、62.9%、82.1%,肺癌结节中,年龄≥55岁较年龄<55岁的明显多,SPN是否具有分叶征、毛刺征、空泡征、胸膜牵拉征在良恶性结节诊断中数据差异有统计学意义,FDG糖代谢SUVmax值良恶性数据无差异。结论^(18)F-FDG PET/CT对偶发性SPN良恶性鉴别有重要价值,影像学特征结合临床资料能够明显提高诊断效能,并能够初步评估肺腺癌的分化程度,可为无法通过穿刺获得病理结果患者提供无创性的诊断手段,同时PET/CT能够修正SPN的诊疗策略。Objective To explore the clinical and imaging features of 18 F-FDG PET/CT imaging in solitary pulmonary nodules(SPN).Methods 106 cases of SPN between July 2009 and July 2016 were analyzed retrospectively.The patients'gender,age,clinical symptoms,laboratory findings and imaging characteristics were collected.Results Among the 106 cases,71 cases were diagnosed as lung cancer,35 cases were benign lesions,46 cases were male and 56 cases were female.The average age was(58.0±11.5)years,the standardized uptake value of nodule was(3.62±3.50).The sensitivity,specificity and accuracy of 18 F-FDG PET/CT examination were 91.6%,62.9%and 82.1%,respectively.The inner and peripheral signs,including spiculation,lobulated,small vacuole sign,and pleural retraction of SPN between benign and malignancy,showed dignificant differences.There were no significant differences in tumor markers and FDG glucose metabolic ratio(T/NT)between benign and malignant groups.Conclusion 18 F-FDG PET/CT imaging play a significant role in differential diagnosis between benign and malignant solitary pulmonary nodules,the diagnostic performance could be obviously improved when PET/CT is combined with patient’s clinical data,meanwhile,the degree of differentiation of lung adenocarcinoma could be assessed preliminarily.It is an ideal and atraumatic diagnostic modality for patients,who could not get pathological results by pulmonary puncture biopsy.

关 键 词：孤立性肺结节 体层摄影术 X线计算机 正电子发射断层显像术 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]