HRCT与PET／CT相结合对孤立性肺癌结节和结核球的鉴别诊断价值

HRCT and PET /CT Combination in Differential Diagnosis of Solitary Pulmonary Carcinoma and Tuberculoma

目的探讨HRCT与PET/CT相结合对孤立性肺癌结节和结核球的鉴别诊断价值。方法回顾性分析经病理或临床证实的孤立性肺癌结节和结核球共60例,全部病例均行PET/CT显像和胸部HRCT检查。PET/CT用目测法结合半定量法判断良恶性,HRCT根据病灶的形态学特征判断良恶性,统计PET/CT诊断结果和HRCT与PET/CT相结合诊断结果。结果病理或临床证实的孤立性肺癌结节和结核球分别为38例和22例,单纯PET/CT正确诊断36例肺癌和14例结核球,2例肺癌PET/CT显像为阴性,其中1例经HRCT和PET/CT联合诊断为恶性;8例结核球PET/CT显像为阳性,其中7例经HRCT和PET/CT结合后正确诊断。单纯PET/CT诊断和联合诊断对孤立性肺癌结节和结核球鉴别的敏感性、特异性和准确性分别为94.74%、63.64%、83.33%和97.37%、95.45%、96.67%。结论 HRCT与PET/CT相结合能大大降低孤立性结核球良恶性判断的假阳性率,可明显提高孤立性肺癌结节和结核球的鉴别的准确性。

Objective To evaluate the value of HRCT and PET/CT in differential diagnosis of solitary lung cancer from tuberculoma. Methods PET/CT and HRCT imaging of 60 patients with isolated lung cancer or tuberculoma confirmed by pathology or clinical followup were retrospectively analyzed. The diagnosis accuracy of PET/CT and combination of HRCT and PET/CT were respectively evaluated. Results 38 cases of solitary lung cancer and 22 cases of tuberculoma were con firmed by the pathological or clinical follow up. PET/CT correctly diagnosed 36 cases of lung cancer and 14 cases of tuber culoma. 2 cases of lung cancer showed negative on PET/CT imaging and 1 of them were correctly diagnosed by HRCT com bined with PET/CT. in 8 cases of tuberculoma, all the lesions showed positive on PET/CT imaging and 7 lesions were cor rectly diagnosed by HRCT combined with PET/CT. The sensitivity, specificity and accuracy of diagnosing solitary lung cancer were 94.74% ,63.64% ,83.33% by utilizing PET/CT singly and 97.37% ,95.45% ,96.67% by HRCT combined with PET/CT. Conclusion HRCT combined with PET/CT can significantly improve the differential diagnosis of solitary lung cancer from tuberculoma.