^(18)F-FDG PET/CT结合高分辨率CT对孤立性肺结节的诊断价值

Evaluation of PET/CT combined with HRCT in differentiating malignant from benign solitary pulmonary nodules

目的探讨18F-脱氧葡萄糖(FDG)PET/CT结合高分辨率CT(HRCT)对孤立性肺结节(SPN)的鉴别诊断价值。方法25例经手术病理检查或治疗随访证实的SPN(共27个)患者,同期行18F-FDG PET/CT显像和病灶部位HRCT检查。18F-FDG PET/CT用目测法结合半定量法判断良恶性,HRCT则根据病灶形态学特征判断良恶性。所得18F-FDG PET/CT结果和18F-FDG PET/CT与HRCT相结合结果分别与病理检查结果对照比较。结果27个SPN中15个恶性,12个良性。PET/ CT正确诊断14个恶性和9个良性SPN。3个良性SPN PET/CT显像为阳性,其中2个经PET/CT和HRCT联合诊断为良性。联合诊断灵敏度和单纯PET/CT相同(93.3%),fH特异性、阳性预测值、阴性预测值、准确性分别高于PET/CT(91.7%、93.3%、91.7%和93.7%对75.0%、82.4%、90.0%和85.2%)。结论18F—FDG PET/CT结合HRCT是有效的无创件鉴别SPN良恶性的方法。

Objective To investigate the clinical value of ^^18F-fluorodeoxyglucose （FDG） PET/CT combined with high resolution CT （HRCT） to differentiate solitary pulmonary nodule （SPN）. Methods 25 patients with 27 SPN were examined with ^18F-FDG PET/CT and HRCT, all of them were proved pathologically or by follow-up. The differential diagnosis of SPN were made using visual method and semi-quantitative method on PET/CT and morphological characteristics on HRCT. The results of ^18 F-FDG PET/CT and ^18F-FDG PET/CT combined with HRCT were compared with pathological results. Results 15 were malignant and 12 benign among the 27 SPN. 14 SPN were positive on PET/CT among 15 malignant SPN with only one negative less than 10 mm in size. 3 benign were positive on PET/CT, but 2 of them were correctly diagnosed as benign by PET/CT combined with HRCT. The specificity, negative predictive value and accuracy of ^18F FDG PET/CT combined with HRCT were higher than that of PET/CT （91.7% , 93.3% , 91.7% and 93.7% vs 75.0%, 82.4%, 90.0% and 85. 2% ）. The sensitivity of PET/CT combined with HRCT and PET/CT alone was same （93.3%）. Conclusion ^18F-FDG PET/CT combined with HRCT is a effective no-invasive method in differentiating malignant SPN from benign.