肺部磨玻璃样病变18F-FDG PET/CT的诊断研究
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摘要
目的 :研究使用氟代脱氧葡萄糖(18F-FDG)派特CT(PET/CT)诊断肺部磨玻璃样病变(ground–glass opacity,GGO)的临床价值。方法 :本次实验所有患者均接受PET/CT诊断和病理学诊断,分析检查图像特征、病灶18F-FDG摄取情况及PET/CT诊断价值。结果 :病理诊断发现,20例患者中6例为腺癌、3例为支气管肺泡癌、2例为腺癌合并支气管肺泡癌、2例为不典型腺瘤增生、7例为炎症或其他良性病变,诊断准确率100%;PET/CT诊断,出现1例误诊,诊断准确率为95.00%,数据比较无明显差异;SUV值计算发现7例<1.0,4例在1.0~2.0之间,9例>2.0,>2.0患者多为腺癌、支气管肺泡癌或两者合并等恶性肿瘤疾病;分析所有患者检查图像发现,发生恶性病变患者检查图像多具有毛刺、分叶、空泡征及胸膜牵拉等特征。结论 :使用18F-FDG PET/CT检查肺部磨玻璃样病变效果显著,诊断准确率高,具有安全、无创等优点,可作为肺部磨玻璃样病变患者首选诊断方法,值得推广。
Objective To investigate the clinical value of fluorodeoxyglucose(18 F-FDG) PET/CT in the diagnosis of groundglass opacity(GGO). Methods All the patients in this experiment were diagnosed by PET/CT and pathological diagnosis to analyze the image features, the uptake of 18 F-FDG and the diagnostic value of PET/CT. Results The pathological diagnosis showed that among the 20 patients, 6 cases of adenocarcinoma, 3 cases of bronchoalveolar carcinoma, 2 cases of adenocarcinoma with bronchial alveolar carcinoma, 2 cases of atypical adenoma hyperplasia, 7 cases of inflammation or other benign lesions, and the diagnostic accuracy rate was 100%; 1 case was misdiagnosed by PET/CT, the diagnostic accuracy rate was 95.00%, there was no significant difference between the data; SUV value calculation found 7 cases <1.0, 4 cases from 1.0 to 2.0, 9 cases> 2.0, > 2.0 patients were mostly adenocarcinoma, bronchial alveolar carcinoma or a combination of both malignant diseases; analysis of all patients examination images found that patients with malignant lesions examination images with more burr, lobulation, vacuoles levy and pleural traction characteristics. Conclusion The results of 18 F-FDG PET/CT for the diagnosis of ground-glass opacity are significant, and the diagnostic accuracy is high. It is safe with non-invasive and can be used as the first choice of diagnosis in patients with ground-glass opacity.
Objective To investigate the clinical value of fluorodeoxyglucose(18 F-FDG) PET/CT in the diagnosis of groundglass opacity(GGO). Methods All the patients in this experiment were diagnosed by PET/CT and pathological diagnosis to analyze the image features, the uptake of 18 F-FDG and the diagnostic value of PET/CT. Results The pathological diagnosis showed that among the 20 patients, 6 cases of adenocarcinoma, 3 cases of bronchoalveolar carcinoma, 2 cases of adenocarcinoma with bronchial alveolar carcinoma, 2 cases of atypical adenoma hyperplasia, 7 cases of inflammation or other benign lesions, and the diagnostic accuracy rate was 100%; 1 case was misdiagnosed by PET/CT, the diagnostic accuracy rate was 95.00%, there was no significant difference between the data; SUV value calculation found 7 cases <1.0, 4 cases from 1.0 to 2.0, 9 cases> 2.0, > 2.0 patients were mostly adenocarcinoma, bronchial alveolar carcinoma or a combination of both malignant diseases; analysis of all patients examination images found that patients with malignant lesions examination images with more burr, lobulation, vacuoles levy and pleural traction characteristics. Conclusion The results of 18 F-FDG PET/CT for the diagnosis of ground-glass opacity are significant, and the diagnostic accuracy is high. It is safe with non-invasive and can be used as the first choice of diagnosis in patients with ground-glass opacity.
引文
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[2]王艳丽,房娜,曾磊,等.18F-FDG PET-CT联合同机HRCT对肺孤立性单纯性磨玻璃结节的诊断价值研究[J].临床放射学杂志,2015,34(2):212-218.
[3]张莹莹,王振光,武凤玉,等.特发性肺间质纤维化HRCT病变区与非病变区18F-FDG PET/CT表现分析[J].国际放射医学核医学杂志,2016,40(6):414-418.
[4]郭悦,陈聪霞,李文婵,等.18F-FDG PET/CT对肺非实性结节诊断价值的探讨[J].中华核医学与分子影像杂志,2015,35(1):5-9.
[5]欧陕兴.常见肺疾病磨玻璃阴影的临床诊断标准(GGO)[C]//全国艾滋病临床影像诊断研讨会.2010.
[6]李国雄,刘志军,张海捷,等.肺硬化性肺泡细胞瘤的18F-FDGPET/CT显像特征[J].中国医学影像技术,2017,33(6):889-892.
[7]韩萍萍,郑玉民,刘晓建,等.肺硬化性血管瘤CT及18F-FDG PET/CT影像特征分析[J].中华核医学与分子影像杂志,2015,35(4):251-253.
[8]张巍,陈谦,龙青松,等.18F-FDG PET/CT联合高分辨率CT在肺癌诊断中的应用[J].中国康复理论与实践,2015,21(6):727-730.
[9]刘晓飞,李鹏程,何宝明,等.18F-FDG PET/CT显像联合血清肿瘤标志物组合在孤立性肺结节诊断中的价值[J].现代肿瘤医学,2017,25(8):1230-1234.
[10]Zhang R,Hu Z,Tan J,et al.A rare case of tonsillar metastatic small cell carcinoma originating from the lung assessed by 18F-FDG PET/CT[J].Revista Espa?ola De Medicina Nuclear E Imagen Molecular,2016,35(6):413-414.
[11]李文婵,陈敏,姚稚明,等.肺单发结核瘤18F-FDG PET/CT误诊分析[J].中国医学影像学杂志,2016,24(10):737-740.
[12]刘文涓,王全师,吴湖炳,等.以^18F-FDG PET/CT和临床信息为基础的孤立性肺结节诊断模型[J].中华核医学与分子影像杂志,2016,36(3):211-215.
[13]彭艳梅,刘翱,樊满齐,等.18F-FDG PET/CT对原发性肺淋巴瘤的诊断价值与疗效评价[J].功能与分子医学影像学杂志(电子版),2017,6(1):1112-1117.
[14]徐丽云,褚海青,李冰,等.18F-PET/CT在肺磨玻璃结节诊断中的应用[J].同济大学学报(医学版),2015,36(5):61-65.
[15]Park S Y,Cho A,Yu W S,et al.Prognostic value of total lesion glycolysis by 18F-FDG PET/CT in surgically resected stage IA non-small cell lung cancer[J].Journal of Nuclear Medicine Official Publication Society of Nuclear Medicine,2015,56(1):45-9.