肺部单发结节在~(18)氟脱氧葡萄糖-正电子发射体层显像检查后外科决策

目的探讨肺部单发结节(SPN)患者在18氟脱氧葡萄糖-正电子发射体层显像(FDG-PET)检查后的外科决策。方法 1998年10月—2006年4月对375例直径1.0～3.0 cm的SPN患者行FDG-PET检查,采用目测法结合半定量分析判读。结果 FDG-PET定性诊断的敏感度、特异度、准确率分别为73.7%(188/255)、71.7%(86/120)、73.1%(274/375);FDG-PET无法区别良性显影病变与腺癌;对于肺外病灶FDG-PET也存在假阳性。结论 PET检查阳性的SPN,除非抗感染或抗结核治疗有效,否则都应当通过手术切除等途径确诊;对PET检查阴性的SPN患者,或手术切除,或定期随访。

Surgical decision based on positron emission tomography using fluorine-18-deoxyglucose in solitary pulmonary nodules

Objective To assess the surgical decisions based on positron emission tomography(PET) using fluorine-18-deoxyglucose(FDG) in solitary pulmonary nodules(SPNs).Methods Three hundred and seventy five consecutive patients underwent FDG-PET for evaluation of SPNs 1.0~3.0 cm in diameter between October 1998 and April 2006.Visual interpretation and semi-quantitative analysis by standard uptake value(SUV) were performed for the FDG-PET data.Results The semi-quantitative method presented a sensitivity,specificity and accuracy of qualitative diagnosis of 73.7%(188/255),71.7%(86/120) and 73.1%(274/375)respectively.FDG-PET failed to differentiate FDG-avid benign pulmonary lesions from adenocarcinoma.The results also revealed false positive for para-pulmonary abnormalities.Conclusion For PET-positive SPNs,surgical resection should be performed for pathological confirmation,unless antibiotic or anti-tuberculosis therapy is effective and for PET-negative SPNs,surgical operation or clinical follow-up should be taken.