^18F-FDG PET/CT对肺炎型细支气管肺泡癌的诊断价值

目的 对比分析肺炎型细支气管肺泡癌（BAC）的^18F-脱氧葡萄糖（^18F-FDG）PET/CT及胸部CT的影像特点,探讨^18F-FDG PET/CT显像对肺炎型BAC的诊断价值.方法 回顾性分析经支气管镜、穿刺细胞学、手术病理和临床随访证实的29倒肺炎型BAC患者及12例肺炎等肺部良性疾病患者的^18F-FDG PET/CT及胸部CT的影像特征,计算前述两种检查方法及单纯^18F-FDG代谢判断肺炎型BAC的灵敏度、特异性及准确性等指标,行X2检验进行比较,必要时行确切概率法Fisher’s分析.结果 肺炎型BAC及肺部良性疾病患者均可表现为FDG高摄取的大片状实变影,在延迟显像中,前者多数（13/18）表现为FDG摄取进一步升高,后者仅少数（1/8）表现为FDG摄取升高,近半数（4/8）表现为FDG摄取减低.18F-FDG PET/CT的诊断灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为80.8％（21/26）,80.0％ （8/10）,78.4％ （29/37）,87.5％ （21/24）和61.5％ （8/13）,灵敏度和准确性明显高于胸部CT 52.2％ （12/23）,54.5％（ 18/33）]（X2=4.54,4 49,P均＜0.05）、特异性明显高于^18F-FDG代谢25.0％（3/12）]（X2=5.23,P＜0.05）.结论 18F-FDG PET/CT显像对肺炎型BAC的诊断及分期具有重要价值,诊断医师应对CT征象和18F-FDG代谢特点（包括延迟显像）进行综合分析,以提高诊断效率.

The Diagnostic Value of 8F-FDG PET/CT in Pneumonic.type Bronchioloalveolar Carcinoma

Objective Pneumonic-type bronchioloalveolar carcinoma（ BAC） has similar features in imaging to pneumonia. The aim of this study was to evaluate the diagnostie value of ^18F-FDG PET/CT in pneumonic-type BAC. Methods This was a retrospective stt,dv on 29 patients with pneumonic-type BAC lesions anti 12 patients with benign pulmonary lesions. The image characters of CT, is F-FDG metab- olism and 18 F-FD（, PET/CT were observed. Sensitivity, specificity ,accuracy, PPV and NPV were calculated and eompared by x^2-test or Fisher＇s. analysis. Results Most of the pneumonic-type BAC lesions anti henign pulmonary lesions had the similar manifestation as mass consolidation with high FDG, uptake. The maximal standardized uptake value（SUVmax） increased in most（13/18） pneumonic-type BAC tumors at delay imaging , however decreased tbr half benign pulmonary lesions. The sensitivity, specifieity,accuracy, PPV and NPV of is F-FDG PET/CT in pneun,onie-type BAC were 80.8% （ 21/26 ） ,80.0% （8/10） ,78.4% （ 29/37 ） ,87.5% （ 21/24 ） and 61.5% （ 8/13 ） respectively. The sensitivity and accuracy were higher than those of CT 52.2% （ 12/23） ,54.5% （18/33） ] （X^2 = 4.54,4.49, P〈 0.05）. The speeificily was higher than that of FDG-PET 25.0% （3/12） ] （X^2 = 5.23, P 〈 0.05）. Conclusion＇s F-FDG PET/CT imaging has very intportant value on diagnosis and staging of pneumonic-type BAC. Diagnosticians should aggregately analyze the signs of chest CT and FDG metabolism in nrder to promote diagnostic efficiency of PET/CT lot pneumonic-lype BAC.