~(18)FDG-PET在肺部病变诊断中的应用

目的　评价18FDG PET在鉴别肺部良恶性病变中的作用。方法　对 2 7例胸部X线片或CT异常的患者进行18FDG PET检查。PET扫描结果是以对目测结果进行定性分析得出的 ,同时采用肺部病变与正常肺组织的FDG摄取比值对病变的良恶性进行鉴别 ,恶性病变此比率 >1 .5 ,而良性病变此比率 <1 .5。以病理学诊断作为金标准 ,PET扫描结果均与其进行比较。结果　 2 7例肺部病变中 2 1例为恶性 (腺癌 8例 ;鳞癌 7例 ;小细胞肺癌 2例 ;大细胞肺癌 1例 ;转移癌 3例 ) ;6例为良性。18FDG PET中肺部病变 /正常肺组织 >1 .5的有 2 0例 ;<1 .5的有 7例。对照术后病理检查结果FDG PET诊断的准确性、敏感性、特异性、阳性预测率、阴性预测率分别为 96 .3 %、95 .2 %、1 0 0 %、1 0 0 %、85 .7%。结论　18FDG PET检查能准确地鉴别肺部病变的良恶性 ,PET扫描是一种非常有用的无创的肺癌诊断方法 ,可为临床提供更为精确和有价值的诊断信息。

FDG-PET in the diagnosis of pulmonary lesions

Objective To evaluate the ability of 18 FDG PET to differentiate benign from malignant pulmonary lesions. Methods Twenty seven patients who had abnormal chest roentgenograms underwent 18 FDG PET. PET scan interpretation was based on visual qualitative analysis of images. Ratio of 18 FDG uptake in the lesion and normal lung tissue assessed visually was used as criteria for differentiation between benign and malignant lesions. Malignant lesions should have lesion/lung ratio larger than 1.5, while benign lesions should have ratio less than 1.5. PET results were compared with pathological results, which were the gold standard. Results Out of the 27 pulmonary lesions, there were 21 malignant (8 cases of adenocarcinoma, 7 squamous cell carcinoma, 2 small cell lung cancer, 1 large cell carcinoma, 3 metastatic carcinoma) and 6 benign lesions. There were 20 cases whose lesion/lung ratio was larger than 1.5 and 7 cases less than 1.5, with an accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 96.3%, 95.2%, 100.0%, 100.0% and 85.7% respectively, for detecting malignant pulmonary lesions. Conclusion 18 FDG PET imaging accurately differentiates malignant from benign pulmonary lesions. PET can be a useful noninvasive test to evaluate indeterminate pulmonary lesions, which will provide us with more accurate and valuable diagnostic information.