^18F-FDG PET-CT结合HRCT诊断细支气管肺泡癌的价值

目的探讨^18F-FDG PET-CT结合HRCT诊断细支气管肺泡癌的价值。方法回顾分析经病理证实的24例细支气管肺泡癌患者的PET-CT及其HRCT图像资料。分别记录其形态学表现及放射性分布，同时测量其最大SUV值（SUVmax）。结果根据形态学表现分为3型：（1）孤立结节型（12例）：表现为密度略不均匀或并有磨玻璃样密度的单发结节，主要征象为分叶、短毛刺、支气管充气征、胸膜凹陷征、空泡征、晕征、血管集束征。SUVmax均值为3．78±1．54；（2）多发结节型（5例）：表现为两肺散在多发的结节，以中下肺叶为主，结节大小不一，小结节无放射性聚积，对于直径〉5mm的结节，SUVmax均值为3．46±1．32。（3）肺炎型（7例）：为一个或多个肺叶的实变。其内见充气支气管征或蜂窝征，放射性分布不均匀，部分病灶FDG摄取为阴性。结论^18F-FDG PET-CT结合HRCT在细支气管肺泡癌的诊断中具有重要的应用价值。诊断时要密切结合PET与HRCT图像，以最大限度地减少误诊。

Value of PET-CT combined with HRCT in diagnosis of bronchioloalveolar carcinoma

Objective To evaluate ^18F- fluorodcoxyglucose（^18F- FDG） PET- CT combined with high resolution Cr（HRCr） in diagnosing bronchioloalveolar carcinoma（BAC）.Methods The PET- CT and HRCr findings in 24 patients with pathologically proved BAC were retrospectively analyzed. Their morphological and radioactive findings were observed,and the maximum standard uptake values（SUVmax） were measured. Results According to the morphology, BAC was classified into 3 types： ①Sohtary nodule （ n = 12） ; Which is characterized by inhomogeneous density or merged groundglass opacity. The main features in this type were lobulation, short speculation, aerated bronchi, pleural indentation, vacuoles, areola sign,and vascular aggregated sign. The mean value of SUVmax was 3.78 ± 1.54.②Multinodules （ n = 5）：the nodules of different size were scattered in peripheral lungs, mainly in middle and lower lungs, the small nodule＇s radioactivity was not observed. As for the nodules over 5 mm in dinmeter, the mean value of SUVmax was 3.46 ± 1.32. ③Pneumonia （ n = 7 ） ： consolidation was observed in one or multiple lobes with ＂aerated bronchi＂ sign or ＂honeycomb＂ sign.Radioactive distribution was inhomogeneous,and FDG uptake in part of lesions was negative. Conclusions The clinical value of ^18F- FDG PET - CT combined with HRCr in diagnosing bronchioloalveolar carcinoma is important. PET and HRCT results should be combined closely,thus the mis diagnosis rate can be reduced.