肺门型肿瘤肺梗死患者临床及^(18)F-FDG PET/CT显像特征  

Clinical and ^(18)F-FDG PET/CT imaging features of hilar tumor pulmonary infarction

作　　者：崔凯 王亚如 郑劲松[2] 崔勇[1] 纪宇[1] Cui Kai;Wang Yaru;Zheng Jingsong;Cui Yong;Ji Yu(Department of Radiology PET/CT,the Second Hospital of Shandong University,Jinan 250033,China;Department of PET/CT,Shandong Cancer Hospital and Institute,Shandong First Medical University,Jinan 250117,China)

机构地区：[1]山东大学第二医院医学影像中心PET/CT室,济南250033 [2]山东第一医科大学附属肿瘤医院、山东省肿瘤防治研究院、山东省肿瘤医院PET/CT室,济南250117

出　　处：《中华核医学与分子影像杂志》2023年第2期75-78,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨肺门型肿瘤肺梗死患者的临床表现及^(18)F-FDG PET/CT显像特征。方法回顾山东大学第二医院及山东第一医科大学附属肿瘤医院2016年7月至2021年6月因肺门肿瘤行^(18)F-FDG PET/CT显像及同期胸部增强CT检查,且通过影像学随访或病理确诊的49例(男40例、女9例,年龄32~81岁)肺梗死患者的资料,分析患者临床及影像学特征。结果^(18)F-FDG PET/CT显像共发现49例患者108个梗死灶。肺门部肿瘤以小细胞癌最常见(67.35%,33/49)。临床表现以咳嗽(69.39%,34/49)和咯血(34.69%,17/49)为主。肺梗死常多发(69.39%,34/49),可多个肺叶受累。梗死灶CT形态表现为楔形(46.30%,50/108)或斑片状(53.70%,58/108),密度以泡状实变为主(61.11%,66/108)。91个(84.26%,91/108)梗死灶呈FDG高代谢,SUV_(max)为1.48~6.62,高代谢模式为边缘征(36.11%,39/108)或不均质高代谢(48.15%,52/108)。有19例(38.78%,19/49)患者合并肺静脉受累;26例(53.06%,26/49)患者伴同侧胸腔积液。结论肺门型肿瘤肺梗死以咳嗽常见。肺门肿瘤患者^(18)F-FDG PET/CT检查时发现外周肺内楔形变、泡状实变、边缘征、不均质高代谢病灶时,有助于对肺门型肿瘤肺梗死的诊断。Objective To investigate the clinical manifestations and ^(18)F-FDG PET/CT imaging features of hilar tumor pulmonary infarction.Methods From July 2016 to June 2021,49 patients(40 males,9 females;age 32-81 years)with hilar tumor pulmonary infarction who underwent PET/CT and enhanced CT in the second Hospital of Shandong University and Shandong Cancer Hospital and Institute,Shandong First Medical University were retrospectively enrolled.All patients were diagnosed by imaging follow-up or pathology.Clinical features and ^(18)F-FDG PET/CT imaging features were analyzed.Results A total of 108 infarcts were found in 49 patients by ^(18)F-FDG PET/CT.Small cell carcinoma was the most common hilar tumor(67.35%,33/49).The most common clinical manifestations of hilar tumor pulmonary infarction were cough(69.39%,34/49)and hemoptysis(34.69%,17/49).Pulmonary infarction was mainly multiple(69.39%,34/49),and multiple lung lobes might be involved.The CT morphology of infarcts was wedge-shaped(46.30%,50/108)or patchy(53.70%,58/108),and the density was mainly bubble consolidation(61.11%,66/108).There were 91(84.26%,91/108)infarcts showing FDG hypermetabolism,with the SUV_(max) of 1.48-6.62,and the hypermetabolism mode was rim sign(36.11%,39/108)or heterogeneous hypermetabolism(48.15%,52/108).Nineteen patients(38.78%,19/49)were complicated with pulmonary vein involvement,and 26 patients(53.06%,26/49)had ipsilateral pleural effusion.Conclusions Hilar tumor pulmonary infarction is characterized by cough.It is helpful for the diagnosis of hilar tumor pulmonary infarction in patients with hilar tumor when wedge-shaped,bubble consolidation,rim sign and heterogeneous hypermetabolism lesions are found in ^(18)F-FDG PET/CT images.

关 键 词：肺肿瘤 肺梗死 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 

分 类 号：R734.2[医药卫生—肿瘤]