PET／CT在胸水诊断中的应用

目的评价18F—FDGPET／CT在胸水良恶性判定中的作用。方法回顾2007年8月-2009年6月我中心以胸水原因待查且常规胸部CT检查仍不能明确胸水性质，行PET／CT检查的病人共59例，男43例，女16例。恶性胸水经病理学证实，包括组织活检、胸膜活检及胸水脱落细胞学检测。PET／CT图像分析分为胸膜有无转移及原发恶性病变和胸膜外远处转移病变两个方面。结果随访5-18个月，恶性胸水23例，良性22例，14例不能判定良恶性。PET／CT判断有无胸膜转移的灵敏度和特异性分别为73．9％和81．8％；发现原发病变11例，胸膜外远处转移10例；指导穿刺6例。结论PET／CT引导下活检穿刺具有良好的临床应用前景。

Application of 18F-FDG PET/CT in diagnosis of hydrothorax

Objective To evaluate the role of 18F-FDG PET/CT in differential diagnosis of hydrothorax. Methods PET/CT was performed for 59 patients （43 males, 16 females） during August 2007- June 2009 in our department due to unexplained hydrothorax which could not be definitely diagnosed by routine chest CT. Malignant hydrothorax was confirmed by pathological examinations, including tissue biopsy, pleural biopsy, and cytological examination of exfoliated cells in hydrothorax. PET/CT image analysis showed pleural metastasis, primary lesions, and distal extra-pleural metastasis. Results Of the 59 patients who were followed up for 5-18 months, 23 had malignant hydrothorax, 22 had benign hydrothorax, and 14 had hydrothorax with unknown etiology. The sensitivity and specificity of PET/CT were 73.9% and 81.8%, respectively, for pleural metastasis. PET/CT showed primary lesions and distal extra-pleural metastasis in 11 and 10 cases, respectively. PET/CT-guided biopsy was performed in 6 cases. Conclusion 18F-FDG PET/CT-guided biopsy has a promising prospect in differential diagnosis of hydrothorax.