^(18)F-FDG PET/CT结合高分辨率CT对孤立性肺结节的诊断价值

Diagnostic value of ^(18)F-FDG PET/CT with HRCT in differentiating solitary pulmonary nodules

目的探讨^(18)F-FDG PET/CT显像结合高分辨率CT(high resolution CT,HRCT)对孤立性肺结节(solitary pulmonary nodule,SPN)的诊断价值。方法回顾性分析124例SPN患者的^(18)F-FDG PET/CT检查资料,其中76例加做HRCT扫描,所有病例经病理或临床随访证实。^(18)F-FDG PET/CT通过目测法和半定量法判断病灶的代谢情况,结合CT或HRCT病灶的形态学特征判断良、恶性。结果 48例仅行^(18)F-FDG PET/CT检查的SPN患者,正确诊断32例为恶性,8例为良性,假阳性与假阴性各4例。76例加做HRCT的患者,正确诊断62例恶性与8例良性,假阳性与假阴性分别为2例和4例。^(18)F-FDG PET/CT结合HRCT与单纯^(18)F-FDG PET/CT诊断SPN的灵敏度、特异性及准确率分别为94%、80%、90%与89%、67%、83%。结论^(18)F-FDG PET/CT协同HRCT可提高对SPN性质判断的灵敏度、特异性及准确率。

Objective To investigate the diagnostic value of ^18F-FDG position emission tomography/computed tomography（ PET-CT） combined with high-resolution CT（ HRCT） for differentiating solitary pulmonary nodules（ SPNs）. Methods The clinical data on 124 patients with SPNs was retrospectively analyzed. All these patients underwent preoperative ^18F-FDG PET/CT,and 76 of them were also subjected to HRCT. Each of these cases was confirmed pathologically or by clinical follow-up. Differential diagnosis of SPNs was made using morphological features in CT/HRCT,visually detectable metabolism and semi-quantitative method. Results Of the 48 patients examined with ^18F-FDG PET/CT alone,32 malignant SPNs and 8 benign ones were diagnosed correctly,but there were 4 false positive ones and 4 false negative ones. Among the 76 cases examined with ^18F-FDG PET/CT plus HRCT,62 malignant and8 benign SPNs were diagnosed correctly,with 2 false positive and 4 false negative ones. The sensitivity,specificity and accuracy of ^18FFDG PET/CT combined with HRCT were higher than those of PET/CT alone（ 94%,80% and 90% vs 89%,67% and 83%）.Conclusions ^18F-FDG PET/CT combined with HRCT can improve the sensitivity,specificity and accuracy in differentiating SPN.