^18F—FDG PET—CT结合HRCT诊断肺部炎性肿块的价值

目的探讨^18F-FDG PET-CT结合HRCT诊断肺部炎性肿块的价值。方法回顺分析经病理证实的20例肺部炎性肿块患者的^18F-FDG PET-CT及其HRCT图像资料，分别记录其形态学表现及放射性分们，同时测量其最大标7传摄取值（SUVmax）。结果根据形态学表现分为3型：a）结节型（5例），表现为密度不均匀的单发结节，主要征象为边缘何长毛刺，桃，犬征，晕征，PET示放射性摄取增高，病灶周围有略低代谢的晕，SUVmax均值为5．64±0．56；b）支气管血管束浸润型（7例），表现为局限于一个肺段或跨段分布的沿支气管血管束分印的类圆型或片状密度增高影，其K轴与肺段走行一敏，边缘模糊或平直，密度不均，内有含气支气管影，部分支气管见截断，PET示放射性摄取增高，病灶内见两个或两个以上结节样浓聚灯，SUVmax均值勾6．36±1．32；c）胸膜下型（8例），表现为肺野周边的团块影，病变基底位于胸膜，并与临近胸膜相连，相邻壁层胸膜见增厚，内缘可吧扫帚征。PET-CT示病灶内放射性分柿不均，内见两个或两个以上结节样浓聚灶或环状代谢增岛，SUVmax均值为7．39±1．13。延迟扫捕3种类型肺炎性肿缺SUVmax均可上升或下降。结论^18F-FDG PET-CT结合HRCT诊断肺部炎性刖，块存在一定的特异征象，具有重要的应用价值。

Value of 18F-FDG PET-CT combined with HRCT for diagnosing pulmonary inflammatory masses

Objective To investigate the value of ^18F-fluorodeoxyglucose pnsitrnn emission tomography （^18F-FDG PET） combined with high resolution computed tomography （HRCT） for diagnnsing puhnonary inflammatory masses（PIM）. Methods The PET-CT and ttRCT findings of 20 patients with pathologically proved PIM were retrospeetively analyzed,which comprised the records of morphologie appearances and radioactive distribution as well as the measurements of maximum standard uptake value （SUV max）. Results According to the morphology of PIM,all the lesions eouht be classified into following three patterns： a）nodule pattern （u=5）appeared as single nodule with nonhomogeneous density and was mainly characterized hy long spiculation,pcach-tip sign and halo sign nceuning in nodal horders.PET showed highly radioactive uptake with peripheral halo of slightly lower metahnlism,the mean value of SUVmax was 5.64±0.56;b） bronchovascular bundle infihration pattern （n=7）appeared as round -like or patchy shadnws with high density and lnealized in a lung segment or across to lung segment along bronchnvascular bundle distribution, whose long axises were corresponding to lung segment and were characterized by hazy or straight edge with nonhomogenenus density and airbrnnehngram with part hronchi interrupt. PET showed highly radioactive uptake ,there were two or over two nodular foci with radinactiveconeentration in alesinn,the mean SUVmax was6.36±1.32x） suhpleuralpattern （n=8） appeared as peripulmonal7 mass shadows whose hases located on the pleurae and adhered to neighbor pleurae,the mural pleurae we, re thickening, in which the ＂bronm sign＂could he fnund. PET showed nonhomogeneously radioactive distribution in the lesions,simuhaneously,two or over two foci with nodular coneentration or circular high metaholism could be found in a lesion,the mean SUV max was 7.39±1.13. The SUVmax of all lesions couht be increasing or decreasing during the delay scanning. Conclusion Some imaging features of PIM on PET-CT cnmhined HRCT have important value for accurately diagnosing this disease.