肺部良性结节性病变^(18)F-脱氧葡萄糖正电子发射体层摄影术检查

Fluorine-18 fluorodeoxyglucose uptake in patients with benign pulmonary nodules

目的探讨肺部良性结节性病变18F-脱氧葡萄糖(FDG)正电子发射体层摄影术(PET)检查的显像特点。方法回顾分析1998年10月—2004年7月间的47例肺部良性结节性病变患者的FDG-PET检查资料,PET结果采用目测法判读,半定量分析法测量显影病灶的最大与平均标准摄取值(SUVm ax与SUVm ean)、正常肺组织的标准摄取值(SUV lung)。所有患者的病变均手术切除明确诊断,其中17例结核性干酪样坏死、17例钙化及纤维化结节、6例炎性假瘤、3例新型隐球菌性肉芽肿、2例硬化性血管瘤、2例错构瘤。结果21例病变FDG-PET检查未显影,包括钙化及纤维化结节、错构瘤以及硬化性血管瘤。26例病变或浓或淡显影,半定量分析病变组织的FDG摄取高于相应的正常肺组织(P<0.001),SUVm ax、SUVm ean和SUV lung分别为3.04±1.65,2.48±1.35和0.40±0.07,其中9例(35%)患者的SUVm ean与11例患者的SUVm ax高于2.5;SUV与病变大小无相关性(P>0.05)。结论肺部良性结节性病变中一部分炎性结节表现为高代谢。

Objective To assess the features of fluorine-18 fluorodeoxyglueose （FDG） uptake in patients with benign pulmonary nodules. Methods From October 1998 to July 2004, 47 patients with benign pulmonary nodules were imaged with FDG-positron emission tomography （PET）. Diagnoses were confirmed by surgery. FDG-PET data was analyzed by visual method and semiquatitative method. When pulmonary nodules with abnormal FDG uptaking appeared in PET scans confirmed by visual method, their maximum and mean standard uptake value （SUVmax and SUVmean） and SUV of normal lung （SUVlung） were measured using semiquantitative method. Results Twenty-one cases showed nothing abnormal in PET scans, including 17 calcification and fibrosis, 2 harmatomas and 2 sclerosing hemangiomas. 26 pulmonary nodules were detected by FDG-PET（ 17 active tuberculous, 6 inflammatory pseudotumors, 3 cryptocdcosis）. FDG uptake of these 26 nodules was higher than that of normal lung （ SUVmax, SUVmean and SUVlung were 3.04±1.65,2.48±1.35 and 0. 40± 0. 07, respectively, P〈0. 001 ）. Correlations were not found between FDG uptake and nodule size or SUV of normal lung or age or blood glucose level in these 26 patients （ P 〉 0. 05）. SUV in 9 cases （9/26, 35% ） were beyond 2.5. Conclusions Some benign pulmonary nodules were FDG avid.