CAJ | 학술논문

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.
목적 탐토18F-FDG PET/CT현상대고립성폐병변적진단개치급오진원인.방법 회고분석32례고립성폐부병변환자18F-FDG PET/CT현상결과.장PET/CT결과여병리검사결과진행대비,평개18F-FDG PET/CT현상재고립성폐부병변진단중적개치,병분석기오진원인.응용SPSS 16.0연건행통계학분석,SUVmax급SUVmax변화솔(△SUVmax)여병조직경대소관계채용Pearson상관분석.결과 32례고립성폐부병변중,악성병변22례,량성병변10례.18F-FDG PET/CT대68.75％( 22/32)환자진행료준학정성진단.18F-FDG PET/CT현상가음성5례,가양성5례.22례폐부악성병변중,6례악성병변조기SUVmax ＜2.5,5례악성병변△SUVmax＜15％.10례폐부량성병변중,2례량성병변조기SUVmax≥2.5,4례량성병변△SUVmax≥15％.량악성병변SUVmax급△SUVmax유교차.32례폐부병변중,고립성폐부병변최대직경≤3 cm공26례,최대직경＞3 cm공6례,평균(1.98±1.08) cm.SUV max여병변직경대소정정상관(r=0.690,P＜0.01),△SUVmax여병조직경대소무상관성(r=-0.081,P＞0.05).결론 18F-FDG PET/CT재폐부고립성병변정성진단중유중요림상개치,단단순의고SUV max존재불족,응장PET여CT종합분석.
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 18F-FDG PET/CT were enrolled into this study and reviewed retrospectively.All the lesions 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 ( SUVmax,early) or the percentage change in SUVmax between early and delayed phases( ASUVmax ) and the lesion size were tested by Pearson analysis,respectively.Results 18F-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,early was less than 2.5 in 6 of 22 malignant pulmonary lesions.The SUVmax,early in 2 of 10 benign pulmonary lesions was ≥2.5.The △SUVmax was less than 15％ in 5 of 22 malignant pulmonary lesions.As for the 10 benign pulmonary lesions,△SUVmax was ≥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 =0.690,P ＜ 0.01 ),but there was no correlation between △SUVmax and the lesion size (r =- 0.081,P ＞ 0.05).Conclusions 18F-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.