^(18)F-FDG PET/CT在肺黏膜相关淋巴组织淋巴瘤与炎症型非小细胞肺癌鉴别诊断中的价值  

Differential diagnostic value of^(18)F-FDG PET/CT between pulmonary mucosa-associated lymphoid tissue lymphoma and inflammatory-type non-small cell lung cancer

作　　者：柯梢柏 林莉莉 季仲友[1] 李昂 Ke Shaobai;Lin Lili;Ji Zhongyou;Li Ang(Department of PET/CT,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院PET/CT室,福州350001

出　　处：《国际放射医学核医学杂志》2022年第10期585-591,共7页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨^(18)F-氟脱氧葡萄糖(FDG)PET/CT的影像特征在肺黏膜相关淋巴组织(MALT)淋巴瘤及炎症型非小细胞肺癌(NSCLC)中的鉴别诊断价值。方法回顾性分析2015年1月至2020年12月于福建医科大学附属协和医院行^(18)F-FDG PET/CT、肺部表现为类炎症改变并经组织病理学检查确诊的21例肺MALT淋巴瘤患者[男性13例、女性8例,年龄56~74(66.2±5.8)岁]及33例炎症型NSCLC患者[男性20例、女性13例,年龄48~84(64.6±9.6)岁]的临床资料。手动勾画CT及PET的感兴趣区,测量病变最大截面的长径及短径、CT值、最大标准化摄取值(SUVmax)和峰值标准化摄取值(SUVpeak),分析影像征象(病变形态、支气管征、病变位置、淋巴结及脾脏的代谢情况)。采用χ^(2)检验、独立样本t检验及校正t检验比较2组间的差异。结果21例肺MALT淋巴瘤患者中,肿块型少于实变型(28.6%对71.4%),33例炎症型NSCLC患者中,肿块型多于实变型(57.6%对42.4%),二者的差异有统计学意义(χ^(2)=4.342,P=0.037);肺MALT淋巴瘤患者中空气支气管征的比例高于炎症型NSCLC患者(90.5%对75.8%),合并高代谢淋巴结的比例明显低于炎症型NSCLC(14.3%对48.5%),二者的差异均无统计学意义(χ^(2)=0.996、3.288,均P>0.05);肺MALT淋巴瘤患者中单侧发病的比例低于双侧发病(23.8%对85.7%),炎症型NSCLC患者中,单侧发病的比例高于双侧发病(84.8%对15.2%),二者的差异有统计学意义(χ^(2)=26.133,P<0.001);肺MALT淋巴瘤患者中脾脏高代谢者11例(52.4%),炎症型NSCLC患者中未见脾脏高代谢者,二者的差异有统计学意义(χ^(2)=21.708,P<0.001)。肺MALT淋巴瘤患者的长径和短径较炎症型NSCLC患者短[(5.89±2.14)cm对(6.26±2.75)cm、(3.88±1.98)cm对(4.21±1.56)cm],二者的差异均无统计学意义(t=−1.46、−1.87,均P>0.05)。肺MALT淋巴瘤患者的CT值高于炎症型NSCLC患者[(45.4±10.5)HU对(21.6±50.1)HU],且差异有统计学意义(t=30.89,P<0.001);肺MALT淋巴瘤患者的Objective To investigate the imaging features of^(18)F-fluorodeoxyglucose(FDG)PET/CT in pulmonary mucosa-associated lymphoid tissue(MALT)lymphoma and differential diagnosis value in inflammatory-type non-small cell lung cancer(NSCLC).Methods Retrospectively analyzed the clinical data of 21 patients with pulmonary MALT lymphoma(13 males and 8 females,aged 56~74(66.2±5.8)and 33 patients with inflammatory-type NSCLC(20 males and 13 females,aged 48~84(64.6±9.6)),respectively,who underwent^(18)F-FDG PET/CT from January 2015 to December 2020 at Fujian Medical University Union Hospital.In addition,the included patients were those whose lungs showed inflammation-like changes and were confirmed by histopathological examination.The CT and PET regions of interest were manually outlined.Then,the long and short diameters of the largest cross-sections of the lesions,CT values,maximum standardized uptake values(SUVmax),and peak standardized uptake values(SUVpeak)were measured.Moreover,the imaging signs(lesion morphology,bronchial signs,location of lesion onset,lymph node and spleen metabolism)were analyzed.The differences between the two groups were subsequently compared using theχ^(2)test,independent samples t-test,and corrected t-test.Results There were fewer masses than solids in 21 patients with pulmonary MALT lymphoma(28.6%vs.71.4%)and more masses than solids in 33 patients with inflammatory-type NSCLC(57.6%vs.42.4%),with a statistically significant difference between the two groups(χ^(2)=4.342,P=0.037);the proportion of bronchial signs was higher in patients with pulmonary MALT lymphoma than that in patients with inflammatory-type NSCLC(90.5%vs.75.8%),and the proportion of combined hypermetabolic lymph nodes was significantly lower than that in inflammatory-type NSCLC(14.3%vs.48.5%),with no statistically significant difference between the two group(χ^(2)=0.996,3.288;both P>0.05);there were fewer unilateral than bilateral morbidities in patients with pulmonary MALT lymphoma(23.8%vs.85.7%)and more unilateral than bilat

关 键 词：氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 X线计算机 癌 非小细胞肺 淋巴瘤 B细胞 边缘区 肺肿瘤 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]