原发性支气管肺类癌的^(18)F-FDG PET/CT诊断价值

Diagnostic value of ^(18)F-FDG PET/CT on primary bronchial-pulmonary carcinoid

目的:探讨18F-FDGPET/CT对支气管肺类癌的诊断价值。方法:回顾性分析7例胸片及CT和18F-FDGPET/CT检查的周围型支气管肺类癌,分析病灶的影像学特点、测定PET/CT标准摄取值,并与病理结果对照分析。结果:本组病例右上肺尖段和前段各1例,右肺中叶1例,右肺下叶2例,左肺上叶尖后段和下叶背段各1例。病灶直径3.4￣6.2cm,平均5.4cm。CT显示病灶形态为肺内类圆形或不规则形软组织密度结节或肿块,病灶内密度均匀,边界清楚,其中2例有浅分叶,2例有短毛刺征,1例病灶周围可见条片影,2例边缘光滑。病灶均表现为病灶内18F-FDG轻度或明显增高,SUV值为3.3±1.4(2.8￣5.3),2例病灶内放射性分布不均匀,可见不规则斑片状及条索状放射性缺损影。1例表现为纵隔和腹腔淋巴结FDG摄取增高。手术病理均证实为非典型神经内分泌癌(类癌)及1例纵隔淋巴结转移。结论:PET显像可清晰显示支气管肺类癌的FDG异常浓集,根据病灶的浓集程度和结构变化对病灶的恶性程度进行判断。同时CT可对病灶进行精确定位并对病灶与周围组织的关系方面为疾病的判断提供详细的资料。

Objective： approach to the diagnostic value of ^18F-FDG PET/CT on primary bronchial-pulmonary carcinoid. Methods： 7 cases of peripheral bronchial-pulmonary carcinoid checked with CT and ^18F-FDG PET/CT were analyzed retrospectively,the image characteristics,PET/CT standard uptake values were measured and compared with pathology results. Results： carcinoid were found 1 on apex and frontal of the upper right lung each,1 on middle lobe,2 on lower right lung,and 1 on apicoposterior segment of the upper left lung and posterior of lower segment each. The diameter were 3.4- 6.2 cm,average 5.4 cm. CT shows the lesions were round or irregular nodus with clear edge and even density similar to soft tissue,2 among which were slightly lobulated, 1 with spicular sign and 1 with patching shade around. ^18F-FDG in all 7 cases were slight or significantly increased,SUV valued 3.3 ± 1.4（2.8-5.3）,2 cases showed uneven distribution with irregular patching and linear defect. FDG uptake in mediastinal and celiac lymph nodes were increased in 1 case. All cases were later proven to be atypical neuroendocrine carcoma carcinoid by surgical pathology and 1 case with mediastinal lymph nodes metastasis Conclusion： bronchial-pulmonary carcinoid can clearly be shown by abnormal FDG concentration on PET image,and its malignancy can be judged base on concentration and structural changes,meanwhile,CT can precisely locate the lesion and provide detailed data of its relationship with surrounding tissue.