PET-CT联合HRCT扫描对不同大小孤立性肺结节良恶性鉴别的临床价值  

PET/CT combing with HRCT in differential diagnosis of solitary pulmonary nodule with different size

作　　者：郭玲玲[1] 卢其玲[1] 邵明岩[2] 王川红[3] GUO Lingling;LU Qiling;SHAO Mingyan(Department of Respiratory Medicine,Jiangxi Privence Pepole’s Hosptial,Nanchang,330006,China;Department of PET/CT Centre,Jiangxi Privence Pepole’s Hosptial,Nanchang,330006,China;Department of Medical Imaging Center;Jiangxi Privence Pepole’s Hosptial,Nanchang,330006,China)

机构地区：[1]江西省人民医院呼吸科,南昌330006 [2]江西省人民医院PET/CT中心,南昌330006 [3]江西省人民医院医学影像中心,南昌330006

出　　处：《江西医药》2018年第11期1197-1199,1218,共4页Jiangxi Medical Journal

基　　金：江西省卫生计生委科技计划;编号20165071

摘　　要：目的探讨PET-CT联合HRCT扫描对不同大小孤立性肺结节(solitary pulmonary nodules,SPN)良恶性鉴别的临床价值。方法纳入我院2016年1月至2018年6月行HRCT扫描及18-氟脱氧葡萄糖(18F-FDG)PET/CT扫描发现的SPN患者82例。根据结节大小分为A型SPN(结节直径<1cm,15例),B型SPN(结节直径1cm≤直径<2cm,34例),C型SPN(结节直径2cm≤直径<3cm,33例);CT室判断:良性结节组27例,恶性结节组55例;PET/CT判断:良性结节组37例,恶性结节组45例;PET/CT联合HRCT判断:良性结节组39例,恶性结节组43例。根据呼吸内科、胸外科、肿瘤科医生的多学科讨论及病人自己的意愿进行:外科手术36例,经皮肺穿刺15例,内科治疗(抗感染、抗结核等)20例,动态随访组11例。结果经病理及随访证实36个为恶性结节,46个为良性结节。HRCT、PET/CT及PET/CT联合HRCT诊断A型SPN的准确率分别为66.7%,73.3%,86.7%;诊断B型SPN的准确率分别为58.8%,82.3%,85.3%;诊断C型SPN的准确率分别为69.7%,81.8%,90.9%。结论 PET/CT联合HRCT可以提高对不同大小SPN诊断的准确率。Objective To evaluate the value of PET/CT combing with HRCT in differential diagnosis of solitary pulmonary nodule with different size.Methods 82 solitary pulmonary nodules were examined with PET/CT and HRCT in our hospital from January 2016 to June 2018.All of the SPN were proven by pathology and follow-up.The SPN were divided into three size:Type A(SPN<1cm,15cases);Type B(1cm≤SPN<2cm,34 cases);Type C(2cm≤SPN<3cm,33 cases).HRCT diagnosis:benign SPN 27 cases,malignant SPN 55 cases;PET/CT diagnosis:benign SPN 37 cases,malignant SPN 45 cases;PET/CT combine with HRCT diagnosis:benign SPN 39 cases,malignant SPN 43 cases.Then,according to the multi-disciplinary discussion of respiratory physcian,thoracic surgeon and oncologist,at the same time according to the patient’s opinion,all the patients were divided into 4 groups:operation 36 cases,percutaneous lung puncture 15 cases,medical treatment 20 cases,follow-up 11cases.Results 36 malignant SPN and 46 benign SPN were confirmed by pathology and follow-up.The accuracy rates of HRCT,PET/CT and PET/CT combine with HRCT in the diagnosis of type A SPN were 66.7%,73.3%and 86.7%respectively,type B SPN were 58.8%,82.3%and 85.3%respectively,type C SPN were 69.7%,81.8%and 90.9%respectively.Condusion PET/CT combining with HRCT can raise the accuracy rate in the diagnosis of SPN with different size.

关 键 词：HRCT 高分辨CT PET/CT 孤立性肺结节 

分 类 号：R563[医药卫生—呼吸系统]