Ⅱ期肺结节病18F-FDG PET/CT影像诊断分析  

Analysis onthe diagnose of stage Ⅱ pulmonary sarcoidosis by using F-FDG PET/CT imaging

作　　者：陈彩龙[1] 林美福[1] 陈文新[1] 周硕[1] 曹登敏 陈国宝[1] 李君霞[1] CHEN Cai-long(Department of nuclear medicine,Fujian provincial hospital,Fuzhou,Fujian,350001,China)

机构地区：[1]福建省立医院核医学科,福建福州350001

出　　处：《齐齐哈尔医学院学报》2020年第16期2016-2018,共3页Journal of Qiqihar Medical University

摘　　要：目的分析总结Ⅱ期肺结节病18F-FDG PET/CT的影像特征,探讨其临床诊断价值。方法分析福建省立医院经病理及临床治疗随访证实的12例Ⅱ期肺结节病18F-FDG PET/CT显像结果及其中4例肺部增强CT资料,采用视觉观察法观察病灶的部位和形态,计算标准摄取值(SUV)。结果 12例患者均有纵隔及肺门淋巴结肿大,大部分累及范围广泛(1~10组),且较对称,淋巴结大部分呈串珠样排列,4例增强扫描淋巴结呈均均匀性强化,无明显融合、血管包绕征象;12例患者肿大淋巴结均明显放射性异常浓聚。12例患者肺部可见沿肺门旁支气管血管周围间质和胸膜下间质分布粟粒样影、小结节影、斑片及细网格样影等,其中3例病灶放射性摄取增高,其余8例无明显放射性异常浓聚。12例患者中有6例合并肺外脏器累及。结论Ⅱ期肺结节病18F-FDG PET/CT显像典型表现为呈串珠状分布于双侧肺门及纵隔肿大淋巴结,无明显融合、强化均匀,代谢增高,但部分患者结节分布可更为广泛且不规律,由于结节病常累及全身多个脏器,18F-FDG PET/CT显像从代谢角度更能全面清晰显示肺内病灶及肺外脏器累及情况,对肺结节病的诊断、分期、疗效评估方面具有较高的临床应用价值。Objective To analyze and summarize the 18F-FDG PET/CTimaging features of stage Ⅱ pulmonary sarcoidosis,and to explore its clinical diagnostic value.Methods The imaging results of 18F-FDG PET/CT in 12 cases of stage Ⅱ pulmonary sarcoidosis those confirmed by pathology and clinical follow-up in Fujian provincial hospital,and the enhanced CT data of 4 cases were analyzedretrospectively.The location and morphology of the lesions were observed by visual observation,and the standard uptake value(SUV) was calculated.Results All the 12 patients had mediastinal and hilus pulmonis lymph node enlargement,most of which involved a wide range(1~10 groups) and were symmetrical,most of the lymph nodes presenting beaded arrangement.The enhanced scanning of the 4 patients presented lymph nodeshomogeneous enhancement,without obvious fusion or vascular envelopment signs.All the 12 patients had abnormal radioactive concentration in enlarged lymph nodes.Miliary shadow,small nodule shadow,patchy and fine mesh shadow located along theperibronchovascularmesenchyme and subpleural mesenchyme was observed in the lung of 12 patients,among which 3 patients had increased radiation uptake,while the remaining 8 had no obvious abnormal concentration of radiation.Among the 12 patients.there were 6 patients complicated with involvement of extra-pulmonary organs.Conclusions Typical presentations of phase Ⅱ pulmonary sarcoidosis 18F-FDG PET/CT imaging were enlarged lymph nodes in bilateral hilar and mediastinum in beaded arrangement,without obvious fusion,uniformly strengthen,increased metabolism.However,in some patients the distribution of noduleis wider and irregular,due to sarcoidosis often involving multiple organs throughout the body,18F-FDG PET/CT imaging fully and clearly view demonstrates the focal area of the lungs and extra-pulmonary organ involvementfrom the perspective of metabolic,it has high clinical value in the diagnosis,installment,curative effect evaluation aspectsof pulmonary sarcoidosis.

关 键 词：结节病 发射型计算机体层显像 18F-FDG 

分 类 号：R445.6[医药卫生—影像医学与核医学]