CT及PET/CT诊断原发性肺动脉肉瘤的价值  

The value of CT and PET/CT in the diagnosis of primary pulmonary artery sarcoma

作　　者：赖婷 胡剑锋 邓宇[2] 李家良 雷永霞[2] LAI Ting;HU Jian-feng;DENG Yu;LI Jia-liang;LEI Yong-xia(Department of Imaging,Guangdong Provincial Hospital of Traditional Chinese Medicine,the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510000,China;Department of Radiology,the First Affliated Hospital of Guangzhou Medical University,Guangzhou 510000,China)

机构地区：[1]广东省中医院(广州中医药大学第二附属医院)影像科,广东广州510000 [2]广州医科大学附属第一医院放射科,广东广州510000

出　　处：《中国临床医学影像杂志》2023年第2期101-104,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:分析原发性肺动脉肉瘤(Pulmonary artery sarcoma,PAS)的CT及PET/CT表现,评价其诊断价值。方法:回顾性分析13例经病理证实的原发性PAS的临床资料、CT及PET/CT表现。结果:本组病例均呈中央型分布,主要累及肺动脉主干及左右肺动脉干,10例延伸至叶、段肺动脉,1例右室流出道及肺动脉瓣亦受累。13例CTPA均显示肺动脉内充盈缺损,12例近心端隆起,8例见“蚀壁征”,4例见“三叶草征”,增强表现呈轻至中度强化。3例伴肺动脉外转移。9例PET/CT中8例病灶糖代谢摄取明显升高,平均SUVmax为8.8±4.3。结论:PAS的CT影像表现为中央型分布的肺动脉内充盈缺损,可有“蚀壁征”或“三叶草征”,增强表现为轻至中度强化。PET/CT上18F-FDG摄取增高有助于诊断PAS。Objective: To analyze the CT and PET/CT manifestations of primary pulmonary artery sarcoma(PAS) and evaluate the diagnostic value. Methods: The clinical data and CT, PET/CT manifestations of 13 patients with pathologically confirmed PAS were analyzed retrospectively. Results: All lesions in our study were distributed centrally, mainly involving the main pulmonary artery and bilateral pulmonary arteries, of which 10 cases extended to the lobe and segment pulmonary artery,and 1 case involved the right ventricular outflow tract and pulmonary valve. Thirteen cases of CTPA showed intraluminal defects, with 12 cases of bulging proximally. Eight cases showed a sign of wall eclipsing, and clover sign was found in 4 cases.All lesions showed mild to moderate enhancement. Three patients developed distant metastases out of pulmonary artery. Among the 9 cases with PET/CT, the glucose metabolic uptake of 8 cases showed significantly increasing, with the average SUVmax of tumors was 8.8 ±4.3. Conclusion: The CT manifestations of PAS showed a centrally distributed filling defect in the pulmonary artery with a sign of wall eclipsing or clover sign, which showed mild to moderate enhancement. Increased18F-FDG uptake on PET/CT helped to diagnose PAS.

关 键 词：肉瘤 肺肿瘤 正电子发射断层显像计算机体层摄影术 氟脱氧葡萄糖F18 

分 类 号：R734.2[医药卫生—肿瘤] R738.7[医药卫生—临床医学] R817.4