硬化性肺细胞瘤与孤立实性结节肺癌的18F-FDG PET/CT特征比较  

Comparison of ^(18)F-FDG PET/CT Images of Pulmonary Sclerosing Pneumocytoma and Nodular Lung Cancer

作　　者：董烨[1] 吴湖炳[1] 王全师[1] 周文兰[1] 王丽娟[1] 傅丽兰 DONG Ye;WU Hubing;WANG Quanshi;ZHOU Wenlan;WANG Lijuan;FU Lilan(Department of Center of PET,Nanfang Hospital Affiliated to Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院PET中心,广东广州510515

出　　处：《中国医学影像学杂志》2018年第6期409-413,421,共6页Chinese Journal of Medical Imaging

摘　　要：目的比较硬化性肺细胞瘤(PSP)和孤立实性结节肺癌的^(18)F-FDG PET/CT特征,探讨可用于鉴别诊断两者的PET和CT征象。资料与方法回顾性分析14例PSP和18例孤立实性结节肺癌患者的PET和薄层CT特征。所有患者分别于术前1周内行全身^(18)F-FDG PET/CT显像,均经病理学检查确诊。比较PSP和孤立实性结节肺癌患者病灶PET和薄层CT征象。结果 PET显像中,PSP的^(18)F-FDG摄取明显低于孤立实性结节肺癌,差异有统计学意义(3.52±1.65比9.02±4.60,t=4.386,P=0.000);但两组病变直径差异无统计学意义[(2.61±1.01)cm比(2.41±0.82)cm,t=0.653,P=0.518]。受试者工作特性曲线分析显示,SUVmax最佳截断值为5.5,以此截断值诊断PSP的敏感度为0.722,特异度为0.933。薄层CT扫描显示,贴边血管征仅见于PSP,而孤立实性结节肺癌无此征象(73.3%比0%),差异有统计学意义(P<0.05);分叶征在两种疾病中均可见,但PSP的阳性率明显低于孤立实性结节肺癌,差异有统计学意义(20.0%比77.8%,P=0.002);毛刺征、胸膜牵拉征、血管集束征及空洞征仅见于孤立实性结节肺癌,差异有统计学意义(P<0.05)。结论 PSP与孤立实性结节肺癌在代谢和形态学征象上有显著差异。将PET和薄层CT两种影像学信息相结合有助于两种疾病的鉴别诊断。Purpose To analyze 18F-FDG PET/CT images of pulmonary sclerosingpneumocytoma(PSP)and nodular lung cancer and investigate the image signs of PET and thin-section CT for differential diagnosis.Materials and Methods Fourteen patients with PSP and 18 patients with nodular lung cancer were enrolled in preset study.All of the patients underwent 18F-FDG PET/CT scans within one week before the operation.The diagnosis was established on pathology.SUVmax,lesion diameter and thin-section CT signs were collected and analyzed.Results On PET images,the uptake of 18F-FDG in PSP lesions was lower than that of nodular lung cancer lesions(3.52±1.65 vs.9.02±4.60,t=4.386,P=0.000).However,no significant difference of lesion diameter was found between both groups[(2.61±1.01)cm vs.(2.41±0.82)cm,t=0.653,P=0.518].The optimal cut-off value of SUVmax determined by ROC curve analysis for differentiating PSP from nodular lung cancer was 5.5.With this cut-off value,the diagnostic sensitivity and specificity of PSP were 0.722 and 0.933,respectively.On thin-section CT,marginal vascular sign was commonly seen in PSP lesions,but not nodular lung cancer(73.3%vs.0%,P<0.05).Lobulation were observed in the two disease,but the positive rate of PSP was significantly lower than that of lung cancer(20%vs.78%,P=0.002).On the other hands,the signs of the lobulation,specular,pleural traction,vascular bundle and cavity were commonly observed in the lesions of nodular lung cancer,but not or seldom in PSP lesions(P<0.05).Conclusion PSP and nodular lung cancer present with different 18F-FDG uptake and thin-section CT signs.The combination of PET and thin-section CT is useful for the differential diagnosis between them.

关 键 词：肺硬化性血管瘤 肺肿瘤 硬币病变 肺 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 诊断 鉴别 

分 类 号：R445.2[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]