结核病的^18F-FDG PET/CT诊断辨析

Differential diagnosis and analysis of tuberculosis by ^18F-FDG PET/CT

结核病可以发生于全身多个脏器,且有多种多样的影像学表现,因此结核病与其他全身性疾病(尤其是肿瘤性疾病)的鉴别较为困难。^18F-FDGPET/CT在全身性疾病的诊断中有一定优势,但工作中仍需结合患者的临床表现、实验室检查、病灶的CT征象及^18F-FDG浓聚程度等信息进行辨析。笔者选取了临床实践中误诊的3个病例,分别为肠结核、肺结核和骨结核,分别从临床特征及^18F-FDGPET/CT影像学表现等方面进行鉴别诊断,梳理诊断思路,以期为临床诊断提供帮助。

Tuberculosis can occur in multiple organs throughout the body. It's difficult to identify tuberculosis and other systemic diseases (especially tumor diseases) because of the different imaging features.^18F-FDG PET/CT has certain advantages in the diagnosis of systemic diseases, but it still needs to be analyzed in combination with clinical manifestations, laboratory tests, CT signs of lesions and concentration of ^18F-FDG. The author select three cases misdiagnosed in clinical practice, namely intestinal tuberculosis, lung tuberculosis and bone tuberculosis, and analyze the clinical features and ^18F-FDG PET/CT imaging features, and comb the diagnosis ideas in order to help with clinical diagnosis.