18F—FDGPET和CT判断肺结核病灶活动性的比较

Comparison between 18F-FDG PET and CT in evaluating the activity of pulmonary tuberculosis

目的评价18F-FDGPET和CT两种影像学方法对肺结核病灶活动性判断的差异。方法对18F-FDGPET．CT显像中发现的31例肺结核病例，分别用CT图像和PET图像对肺结核病灶是否活动进行判断，然后对两种影像学方法的结果进行比较。结果两种方法判断结果一致者26例，不一致者5例。6例CT诊断为非活动性肺结核者（愈合病灶），PET均判断为非活动性病灶；16例CT示病灶大部分钙化、伴有少许索条影（陈旧性病灶）并诊断为非活动性肺结核者中，5例PET判断为活动性病灶，其中3例病灶为结节的未钙化部分放射性轻度浓聚，2例为索条影伴有放射性轻度浓聚；9例CT诊断为活动性肺结核者，PET均判断为活动性病灶。结论18F-FDGPET在判断愈合后的结核病灶和完全处于活动期的结核病灶时，与CT判断结果一致，但在对陈旧性结核病灶是否存在残余活动性病灶的判断上优于CT。

Objective To compare the difference between ISF-FDG PET and CT for evaluating the activity of pulmonary tuberculosis. Methods 18F-FDG PET-CT was performed in 31 pulmonary tuberculosis patients, the activity of the tuberculosis lesions was evaluated by PET and CT images, the results of the two imaging methods were compared separately. Results The results obtained with the two imaging methods were consistent in 26 cases and inconsistent in 5 cases. 6 cases which CT diagnosed as inactive tuberculosis （healed lesions） were also judged as inactive lesions by PET imaging. In 16 cases, CT displayed that most of the lesions were calcified and associated with little streaks and diagnosed as inactive tuberculosis （obsolete lesions）, among them PET judged 5 cases as active lesions, of which 3 cases with partly calcified lesion associated with mild radioactive uptake, 2 cases with streaks associated with mild radioactive uptake. 9 cases which CT diagnosed as active pulmonary tuberculosis, PET judged as active lesions too. Conclusions 18F- FDG PET and CT have the same judgment in diagnosing healed and active tuberculosis lesions, while 18F- FDG PET is superior to CT in evaluating the active lesions residue in obsolete lesions.