刘晓飞 欧阳晓辉 苏家贵 等

[摘要] 目的 探討18F-FDG PET/CT对孤立性肺癌及肺结核瘤的诊断价值。 方法 收集2013年7月～2015年7月经解放军第三〇九医院CT检查且经病理证实的孤立性肺结节（SPN）患者46例的临床资料，其中孤立性肺癌26例、肺结核瘤20例。对其18F-FDG PET/CT的特征进行回顾性分析，依据病理结果将其分为孤立性肺癌组（n=26）和肺结核瘤组（n=20），比较分析两组结节的FDG摄取值（SUV）、病灶分布、形态学特征等。 结果 孤立性肺癌组及肺结核瘤组最大SUV值范围分别为1.3～7.7、1.4～6.5，两组SUV均值比较[（4.18±2.58）比（4.0±2.02）]，差异无统计学意义（P > 0.05）；两组病灶均可发生在双肺各叶，两组病灶分布比较，差异无统计学意义（P > 0.05）；两组分叶征、胸膜牵拉征、空泡征比较，孤立性肺癌组明显高于肺结核瘤组（P < 0.01）；两组病灶大小、毛刺征、空洞征比较，差异无统计学意义（P > 0.05）。 结论 18F-FDG PET/CT在孤立性肺癌与肺结核瘤的诊断及鉴别诊断中具有一定意义。

[关键词] 肺癌；肺结核瘤；体层摄影术；发射型计算机；诊断

[中图分类号] R817.4 [文献标识码] A [文章编号] 1673-7210（2016）02（a）-0060-04

Diagnostic value of 18F-FDG PET/CT in pulmonary tuberculoma and peripheral lung cancer

LIU Xiaofei1 OUYANG Xiaohui1 SU Jiagui1 WANG Zhizhong1 ZHOU Xiaohong1 WANG Zhongyuan2 HE Baoming1

1.Department of Nuclear Medicine， the 309th Hospital of Chinese People's Liberation Army， Beijing 100091， China； 2.Institute of Tuberculosis， the 309th Hospital of Chinese People's Liberation Army， Beijing 100091， China

[Abstract] Objective To discuss value of 18F-FDG PET/CT in diagnosis of solitary peripheral lung cancer and pulmonary tuberculomas. Methods Clinical data of 46 cases with solitary pulmonary nodule from July 2013 to July 2015 CT examined in the 309th Hospital of Chinese People's Liberation Army were included， of which there were 26 cases with solitary peripheral lung cancer and 20 cases with pulmonary tuberculomas confirmed by pathology. The 18F-FDG PET/CT features of were analyzed retrospectively， according to the pathological results， they were divided into solitary peripheral lung cancer group （n=26） and pulmonary tuberculomas group （n=20）， nodules of FDG perturbation values， distribution， morphological characteristics of two groups were analyzed and compared. Results SUV value of the solitary peripheral lung cancer group was 1.3-7.7 （4.18±2.58） and pulmonary tuberculomas ranging group was 1.4-6.5 （4.0±2.02）， the difference of two groups in mean value of SUV was statistically significant （P > 0.05）. Lesions of two groups were occured at all lobes of the two lungs， which showed no statistical difference in lesions distribution between the two groups （P > 0.05）. There were significant difference in solitary peripheral lung cancer group compared with pulmonary tuberculomas group in lobulation sign， vacuole sign and pleural indentation sign （P < 0.01）. There was no significant difference in the proportions of the diameter of the lesions speculation sign and cavitation sign between the two groups （P > 0.05）. Conclusion 18F-FDG PET/CT has certain significance in diagnosis and differential diagnosis of peripheral lung cancer and pulmonary tuberculomas.

[Key words] Lung cancer； Pulmonary tuberculoma； Tomography； Emission； Diagnosis

孤立性肺结节（solitary pulmonary nodule，SPN）是指肺内直径≤3 cm的单发结节状病灶。SPN一直是胸部影像学诊断最富挑战性的课题之一[1]。准确、及时地鉴别SPN的良恶性具有重要的临床价值，既不延误恶性肿瘤患者的手术时机，又可以避免良性肺部病变因行胸部手术而带来的相关并发症。解放军第三〇九医院（以下简称“我院”）为结核病医院，肺结核瘤与孤立性肺癌均为肺内常见结节或肿块性病变，两者治疗方法、预后明显不同，孤立性肺癌通常采取手术治疗及必要辅助放化疗，肺结核瘤通常要抗结核药物治疗，或必要时手术切除。目前，正……