孤立性肺病变18F-FDG PET/CT显像诊断价值及误诊原因分析

目的 探讨18F-FDG PET/CT显像对孤立性肺病变的诊断价值及误诊原因.方法 回顾分析32例孤立性肺部病变患者18F-FDG PET/CT显像结果.将PET/CT结果与病理检查结果进行对比,评价18F-FDG PET/CT显像在孤立性肺部病变诊断中的价值,并分析其误诊原因.应用SPSS 16.0软件行统计学分析,SUVmax及SUVmax变化率(△SUVmax)与病灶直径大小关系采用Pearson相关分析.结果 32例孤立性肺部病变中,恶性病变22例,良性病变10例.18F-FDG PET/CT对68.75％( 22/32)患者进行了准确定性诊断.18F-FDG PET/CT显像假阴性5例,假阳性5例.22例肺部恶性病变中,6例恶性病变早期SUVmax ＜2.5,5例恶性病变△SUVmax＜15％.10例肺部良性病变中,2例良性病变早期SUVmax≥2.5,4例良性病变△SUVmax≥15％.良恶性病变SUVmax及△SUVmax有交叉.32例肺部病变中,孤立性肺部病变最大直径≤3 cm共26例,最大直径＞3 cm共6例,平均(1.98±1.08) cm.SUV max与病变直径大小呈正相关(r=0.690,P＜0.01),△SUVmax与病灶直径大小无相关性(r=-0.081,P＞0.05).结论 18F-FDG PET/CT在肺部孤立性病变定性诊断中有重要临床价值,但单纯依靠SUV max存在不足,应将PET与CT综合分析.

Diagnostic value of 18F-FDG PET/CT in solitary pulmonary lesions and analysis on the causes ofmisdiagnosis

Objective To evaluate the diagnostic value of 18F-FDG PET/CT in solitary pulmonary lesions and to analyze the causes of misdiagnosis. Methods Thirty-two patients with solitary pulmonary lesions detected by is F-FDG PET/CT were enrolled into this study and reviewed retrospectively. All the le- sions were confirmed by histopathology. The possible causes for wrong-interpretation based on 18F-FDG PET/CT findings were investigated. Statistical analysis was performed using SPSS 16.0. The correlations between the SUVmax of early phase （SUV rly ） or the percentage change in SUVmax between early and delayed phases（ ASUVmax ） and the lesion size were tested by Pearson analysis, respectively. Results is F- FDG PET/CT had a detection accuracy of 68.75% （22/32） for solitary pulmonary lesions. Among 32 cases, there were 5 false negatives and 5 false positives based on 18F-FDG PET/CT. The SUVmax was less than 2. 5 in 6 of 22 malignant pulmonary lesions. The SUV fly in 2 of 10 benign pulmonary lesions was I〉2.5. The ASUVmax was less than 15% in 5 of 22 malignant pulmonary lesions. As for the 10 benign pulmonary lesions, ASUVmax, was I〉 15% in 4 cases. The average size （largest dimension） of 32 pulmonary lesions was （ 1.98 ＋ 1.08） cm, with 26 lesions smaller than or equal to 3 cm and 6 lesions larger than 3 cm. The SUVmax was positively correlated with the lesion size （ r = O. 690, P 〈 O. 01 ） , but there was no correlation between ASUVmax and the lesion size （ r = - 0.081, P 〉 O. 05 ）. Conclusions is F-FDG PET/CT plays an important role in the diagnosis of solitary pulmonary lesion. However, SUVmax alone has its limitations; it is best to combine measurements with CT and other diagnostic parameters.