孤立性肺病变18F-FDGPET／CT显像诊断价值及误诊原因分析

Diagnostic value of 18F-FDG PET/CT in solitary pulmonary lesions and analysis on the causes ofmisdiagnosis

目的探讨18F—FDGPET／CT显像对孤立性肺病变的诊断价值及误诊原因。方法回顾分析32例孤立性肺部病变患者18F—FDGPET／CT显像结果。将PET／CT结果与病理检查结果进行对比，评价“F—FDGPET／CT显像在孤立性肺部病变诊断中的价值，并分析其误诊原因。应用SPSS16．0软件行统计学分析，SUV。。及SUV。。变化率（ASUV…）与病灶直径大小关系采用Pearson相关分析。结果32例孤立性肺部病变中，恶性病变22例，良性病变10例。18F．FDGPET／CT对68．75％（22／32）患者进行了准确定性诊断。18F—FDGPET／CT显像假阴性5例，假阳性5例。22例肺部恶性病变中，6例恶性病变早期SUVmax〈2．5，5例恶性病变ASUVmax〈15％。10例肺部良性病变中，2例良性病变早期SUVmax≥2．5，4例良性病变ASUVmax≥15％。良恶性病变SUVmax及ASUVmax有交叉。32例肺部病变中，孤立性肺部病变最大直径≤3cm共26例，最大直径〉3cm共6例，平均（1．98±1．08）cm。SUV。。与病变直径大小呈正相关（r=0．690，P〈0．01），ASUVmax与病灶直径大小无相关性（r=一0．08l，P〉0．05）。结论18F—FDGPET／CT在肺部孤立性病变定性诊断中有重要临床价值，但单纯依靠SUVmax存在不足，应将PET与CT综合分析。

Objective To evaluate the diagnostic value of 18F-FDG PET/CT in solitary pulmonary lesions and to analyze the causes of misdiagnosis. Methods Thirty-two patients with solitary pulmonary lesions detected by is F-FDG PET/CT were enrolled into this study and reviewed retrospectively. All the le- sions were confirmed by histopathology. The possible causes for wrong-interpretation based on 18F-FDG PET/CT findings were investigated. Statistical analysis was performed using SPSS 16.0. The correlations between the SUVmax of early phase （SUV rly ） or the percentage change in SUVmax between early and delayed phases（ ASUVmax ） and the lesion size were tested by Pearson analysis, respectively. Results is F- FDG PET/CT had a detection accuracy of 68.75% （22/32） for solitary pulmonary lesions. Among 32 cases, there were 5 false negatives and 5 false positives based on 18F-FDG PET/CT. The SUVmax was less than 2. 5 in 6 of 22 malignant pulmonary lesions. The SUV fly in 2 of 10 benign pulmonary lesions was I〉2.5. The ASUVmax was less than 15% in 5 of 22 malignant pulmonary lesions. As for the 10 benign pulmonary lesions, ASUVmax, was I〉 15% in 4 cases. The average size （largest dimension） of 32 pulmonary lesions was （ 1.98 ＋ 1.08） cm, with 26 lesions smaller than or equal to 3 cm and 6 lesions larger than 3 cm. The SUVmax was positively correlated with the lesion size （ r = O. 690, P 〈 O. 01 ） , but there was no correlation between ASUVmax and the lesion size （ r = - 0.081, P 〉 O. 05 ）. Conclusions is F-FDG PET/CT plays an important role in the diagnosis of solitary pulmonary lesion. However, SUVmax alone has its limitations; it is best to combine measurements with CT and other diagnostic parameters.