高分辨率CT联合PET/CT对周围型肺癌和结核球的鉴别诊断价值

Value of high resolution CT combined with PETCT in differential diagnosis of peripheral lung cancer and tuberculoma

目的:评估高分辨率CT(high resolution CT,HRCT)联合正电子发射计算机断层显像(positron emission computed tomography,PET/CT)对周围型肺癌和结核球的鉴别诊断价值。方法:回顾分析2019年4月至2021年7月我院收治59例病理或临床证实的周围型肺癌与结核球患者的临床资料,均行HRCT、PET/CT检查。查看两类疾病分布情况与检查诊断结果。结果:周围型肺癌与结核球的分布差异无统计学意义(P>0.05);37例周围型肺癌与22例结核球单纯PET/CT检查:34例周围型肺癌、16例结核球,3例肺癌行PET/CT检查为阴性,6例结核球行PET/CT检查为假阳性;PET/CT并HRCT检查:36例周围型肺癌、20例结核球,1例肺癌行PET/CT并HRCT为阴性,2例结核球行PET/CT并HRCT为阳性;单纯PET/CT检查敏感度91.82%、特异度72.73%、准确度84.75%虽均低于PET/CT并HRCT检查的97.30%、90.91%、94.92%,但差异无统计学意义(P>0.05)。结论:PET/CT联合HRCT检查可提高周围型肺癌和结核球临床诊断的准确性,同时降低假阳性率。

Objective:To evaluate the value of high resolution CT(HRCT)combined with positron emission computed tomography(PET/CT)in the differential diagnosis of peripheral lung cancer and tuberculous globules.Methods:The clinical data of 59 patients with pathologically or clinically confirmed peripheral lung cancer and tuberculous globules admitted to our hospital from April 2017 to July 2018 were retrospectively analyzed.All patients underwent HRCT and PET/CT examination.The distribution of the two types of diseases and the diagnosis results were examined.Results:There was no difference in the distribution of peripheral lung cancer and tuberculous globules(P>0.05).Pathological confirmation:37 cases of peripheral lung cancer and 22 cases of tuberculous globules by PET/CT examination alone:34cases of peripheral lung cancer and 16 cases of tuberculous globules,3 cases of lung cancer by PET/CT examination were negative,6 cases of tuberculous globules by PET/CT examination were false positive.PET/CT combined with HRCT examination:36 cases of peripheral lung cancer and 20 cases of tuberculous bullets,1 case of lung cancer with PET/CT and HRCT was negative,2 cases of tuberculous bullets with PET/CT and HRCT were positive.The sensitivity,specificity and accuracy of PET/CT alone were 91.82%,72.73% and 84.75%,although they are lower than 97.30%,90.91%and 94.92% of PET/CT and HRCT,but there was no significant difference(P>0.05).Conclusion:PET/CT combined with HRCT can improve the accuracy of clinical diagnosis of peripheral lung cancer and tuberculous globules,and reduce the false positive rate.