硬化性肺细胞瘤的18F-FDG PET/CT表现

18F-FDG PET/CT Findings of Pulmonary Sclerosing Pneumocytoma

目的探讨硬化性肺细胞瘤(PSP)的CT与18F-FDG PET/CT表现及病理学特征,以提高本病的诊断水平。资料与方法回顾性分析经手术病理证实的24例PSP患者的影像学资料,其中多层螺旋CT(MSCT)平扫24例、增强扫描18例、18F-FDG PET/CT全身显像9例。分析病灶最大长径与最大标准化摄取值(SUVmax)的相关性。结果24例患者共25枚病灶,最大长径1.1~8.0 cm。MSCT示PSP以密度均匀、圆形或类圆形病灶为主,增强扫描以均匀强化为主。CT主要伴随征象包括晕征、贴边血管征和动脉期细条样血管影等。18F-FDG PET/CT显像病灶呈均匀或不均匀轻-中度结节状、斑片状放射性摄取,SUVmax 1.7~5.3,平均3.5±1.3。病灶最大长径与SUVmax无显著相关性(rs=0.419,P=0.229)。病理镜下见肿瘤主要由乳头状区、硬化区、实性区和血管瘤样区(出血区)4种结构中的2种或多种混合而成。18F-FDG PET/CT代谢较高区域的主要成分一般以乳头状和实性成分为主。结论PSP病理组织结构具有特征性,在MSCT检查中可出现相应征象;18F-FDG PET/CT可以提供病灶的代谢信息。

Purpose To discuss the imaging and pathological features of CT and 18F-FDG PET/CT in pulmonary sclerosing pneumocytoma(PSP),and to provide the diagnosis of PSP.Materials and Methods A retrospective analysis was performed on the imaging data of 24 PSP patients confirmed by surgical pathology,24 cases received MSCT plain scan,18 cases received enhanced scan and 9 cases received whole-body 18F-FDG PET/CT.Results A total of 25 lesions were diagnosed in these 24 patients,and the maximum length of the lesions ranged from 1.1 to 8.0 cm.Moreover,the PSP in MSCT was dominated by the lesions with uniform density and round or round-like shape,and the PSP in enhanced scan was dominated by uniform enhancements.Furthermore,the main CT associated signs included halo signs,welt vessel signs and strip-shape vessels in arterial phase.Besides,the 18F-FDG PET/CT lesion imaging showed uniform or non-uniform radioactive uptake of mild to moderate nodular and patchy,and the SUVmax ranged from 1.7 to 5.3,with average 3.5±1.3.The correlation between the maximum lesion length and SUVmax was not statistically significant(rs=0.419,P=0.229),and microscopically,the tumors were mainly composed of two or more of four structures below:papillary region,sclerosing region,solid region and hemangioma-like region(bleeding region).In addition,the main components in the higher metabolic regions of 18F-FDG PET/CT were papillary and solid components.Conclusion The pathological structure of PSP is characteristic,and corresponding signs could be found in MSCT examination.The metabolic information of the lesions could be provided by 18F-FDG PET/CT.