肺部肉芽肿性炎症的PET/CT特点

Characteristic features of PET/CT in granuloma of the lung

目的本文就肺部肉芽肿性炎症的PET/CT特点进行分析。方法2002～2006年我院共10例肺部肉芽肿性炎症患者行PET/CT检查,分析病灶大小与FDG摄取的关系。结果10例患者18个病灶:结核性肉芽肿7例(11个病灶),肺隐球菌病2例(6个病灶),炎性假瘤1例(1个病灶)。病灶大小0.8～7cm,SUVave值范围从1.8～14.1,平均值5.09,中位数5.50,其中SUVave<2.5的3个,5.5>SUVave≥2.5的6个,SUVave≥5.5的9个。≤2cm的病灶7个,其SUVave、SUVmax、延迟SUVave、延迟SUVmax值分别为(4.09±1.41)、(5.34±2.22)、(4.31±2.18)、(5.91±3.41);>2cm的病灶11个,其SUVave、SUVmax、延迟SUVave、延迟SUVmax值分别为(5.74±3.55)、(7.24±4.32)、(4.67±2.61)、(6.77±4.04)。两组病灶在SUVave、SUVmax、延迟SUVave和延迟SUVmax4项指标之间差异无显著性(P>0.05)。在≤2cm的7个病灶中,延迟显相的SUV值稍增加,但与早期显相的SUV值差异无显著性(P>0.05)。在>2cm的11个病灶中,延迟显相的SUV值稍减低,与早期显相的SUV值亦差异无显著性(P>0.05)。结论肺部肉芽肿性炎症的PEF/CT容易产生假阳性结果,诊断时应仔细鉴别,延迟显相或其他造影剂联合应用可能有助于提高诊断的准确性。

[Objective] To study the characteristic features of PET/CT in granuloma of lung. [Methods] From 2002 to 2006, 10 patients with pulmonary granuloma were imaged with FDG-PET/CT before surgery. The relationship between size of granuloma and FDG uptake was analyzed. [Results] There were 18 granulomas in 10 patients, including 11 tuberculosis （in 7 patients）, 6 cryptococcosis （in 2 patients）, 1 inflammatory pseudotumor （in 1 patient）. The size ranged from 0.8 cm to 7 cm. The average SUV （standard uptake value） ranged from 1.8 to 14.1, with the mean value of 5.09 and the median of 5.50. And there were 3 granulomas with SUVave〈2.5, 6 with 5.5〉SUVave〉2.5 and 9 with SUVave≥5.5. The value of SUVmax,SUVmax delayed SUVave and delayed SUVmax in 7 granulomas with the size≤2 cm was （4.09±1.41）, （5.34±2.22）, （4.31±2.18）, （5.91±3.41）, respectively. And these four values in 11 granulomas with the size〉2 cm were （5.74±3.55）, （7.24±4.32）, （4.67±2.61）, （6.77±4.04）, respectively. There was no significant difference between these two groups. The delayed SUV value was greater than SUV value in granulomas no more than 2 cm, but the difference was not significant. The delayed SUV value was less than SUV value in granulomas bigger than 2cm, and the difference was not significant either. [Conclusion] FDG-PET/CT leads to false positive result in granuloma of lung. And the diagnosis should be made carefully. Delayed imaging or combining with other radioactive tracers might improve the accuracy.