^(18)F-FDG PET/CT在肺部磨玻璃结节良恶性鉴别诊断中的应用价值

Application value of ^(18)F-FDG PET/CT in differential diagnosis of benign and malignant pulmonary ground glass nodules

目的探讨^(18)F-氟代脱氧葡萄糖正电子发射断层显像/计算机体层成像仪(^(18)F-FDG PET/CT)在肺部磨玻璃结节(GGN)良恶性鉴别中的应用价值。方法选择重庆华健友方医院2016年2月至2021年4月具有完整^(18)F-FDG PET/CT影像资料且经手术或穿刺活检病理证实60例患者[63个GGN(直径≥5 mm)]。分析病灶的形态学表现,并计算病灶的最大标准摄取值(SUV_(max))。结果63个GGN中混合性GGN(mGGN)38个(良性7个、恶性31个),纯GGN(pGGN)25个(良性12个、恶性13个)。恶性GGN中腺癌40个、鳞癌2个、腺鳞癌2个;良性GGN中炎症12个、结核6个、肺泡上皮不典型增生1个。良恶性GGN病灶大小、边缘、密度比较,差异有统计学意义(P<0.05);良恶性GGN病灶位置比较,差异无统计学意义(P>0.05)。良恶性mGGN中SUV_(max)≥1.0比较,差异有统计学意义(P<0.05);良恶性pGGN中SUVmax≥1.0比较,差异无统计学意义(P>0.05)。结论^(18)F-FDG PET/CT在肺部GGN良恶性鉴别诊断中能够提供影像及代谢信息,具有重要临床价值。

Objective To explore the application value of^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(^(18)F-FDG PET/CT)in the differrentiation of benign and malignant pulmonary ground glass nodules(GGN).Methods Sixty patients(63 GGN[diameter≥5 mm])with complete^(18)F-FDG PET/CT image data and pathologically confirmed by surgery or puncture biopsy were selected from Chongqing Huajianyoufang Hospital from February 2016 to April 2021.The morphological manifestations of the lesions were analyzed,and maximum standard uptake value(SUV_(max))of lesions were calculated.Results Among the 63 GGN,38 were mixed GGN(7 benign and 31 malignant),and 25 were pure GGN(12 benign and 13 malignant).There were 40 adenocarcinoma,2 squamous cell carcinoma,and 2 adenosquamous cell carcinoma in malignant GGN.There were 12 inflammation,6 tuberculosis,and 1 atypical hyperplasia of alveolar epithelium in benign GGN.There were significant differences in the size,margin,and density of benign and malignant GGN lesions(P<0.05);there was no significant difference in GGN location between benign and malignant(P>0.05).SUV_(max)≥1.0 in benign and malignant mGGN was statistically significant(P<0.05);there was no statistical significance in SUVmax≥1.0 between benign and malignant pGGN(P>0.05).Conclusion^(18)F-FDG PET/CT can provide imaging and metabolic information in the differential diagnosis of benign and malignant pulmonary GGN,which has important clinical value.