^18F-FDGPET／CT和同机CT增强扫描对肺硬化性血管瘤的诊断价值

^18F-FDG PET/CT and contrast-enhanced CT in diagnosis of pulmonary sclerosing hemangioma

目的探讨肺硬化性血管瘤（PSH）的^18F—FDGPET／CT显像和cT增强扫描特征及2种方法对该病的诊断价值。方法回顾性分析2007年6月至2011年6月问，经病理证实为PSH、有同机^18F—FDGPET／CT双时相（早期、延迟）显像、病灶层面高分辨率（HR）CT扫描及多期增强CT扫描资料的5例患者，其中女4例，男1例，发病年龄39～66（平均51．6）岁。对PET／CT早期、延迟显像图及滞留指数，CT扫描的增强净增值、峰值下降时间及“边缘血管征”等进行综合分析。结果PSH在双时相^18F—FDGPET／CT显像上表现为斑片样FDG代谢增高，早期显像SUVmax为3．3±1．1，延迟显像SUVmax增高或降低，平均为3．4±1．4，平均滞留指数为（2．1±20．8）％；HRCT可表现为边界清晰的圆形或类圆形结节或肿块，部分可见“空气新月征”，少数病灶内可见钙化点；多期CT增强扫描显示病灶呈中～高度强化（增强净增值为35～59HU），增强后峰值下降（峰值下降时间为140—260s），5例病例均可见1～4条数量不等的“边缘血管征”。结论PSH^18F—FDGPET／CT显像的肿块或结节的斑片样高代谢表现提示其可能为良性病灶；结合病灶层面的诊断性cT扫描（包括增强）表现，可进一步明确PsH的诊断。

Objective To evaluate the value and characteristics of ^18F-FDG PET/CT and contrastenhanced CT in pulmonary sclerosing hemangioma （PSH）. Methods A retrospective study involving 5 patients confirmed as PSH by pathology from June 2007 to June 2011 was performed. The cases consisted of four women and one man with age ranged from 39 to 66 （ mean 51.6 ） years. All patients received dual- phase is F-FDG PET/CT, high resolution （HR） CT and muhi-phase contrast-enhanced CT （ Siemens Biograph 16 PET/CT）. Lesion SUVmax on early and delayed PET/CT images, retention index, increased HU value, washout time from peak on contrast-enhanced CT and peritumor vessel sign were studied. Results PSH lesions showed patchy increased ISF-FDG uptake with mean SUVmax on early and delayed PET/CT of 3.3 ± 1.1 and 3.4 ± 1.4, respectively. The mean retention index was （2.1 ± 20.8 ） %. The morphological features of PSH on HRCT included findings such as a round/oval nodule or mass with well-defined margins and air meniscus sign. On multi-phase contrast-enhanced CT, PSH showed moderate to high enhancement （the increased value： 35 to 59 HU） with washout times from peak of 140 to 260 s, and 1 to 4 peritumor vessel signs. Conclusions A patchy pattern of high 18F-FDG uptake on PET/CT is suggestive of benign entity. Contrast-enhanced CT findings are very useful to increase the confidence for the diagnosis of PSH.