2015 年第 2 期 第 13 卷

良性肺结节在18F-FDG_PET-CT上的摄取特点

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关键词：硬币病变，肺体层摄影术，发射型计算机体层摄影术，X线计算机脱氧葡萄糖

• 摘要：
• 【摘要】目的 分析良性肺结节的18F-FDG PET-CT摄取特点，提高对良性肺结节的诊断和鉴别诊断能力。方法 回顾性分析121例良性肺结节患者的18F-FDG PET-CT表现。98例结节行病灶处延迟扫描。所有病例通过组织学或诊断性治疗或随诊证实。结果 121例良性肺结节按照其病理类型分为：（1）46例炎症，（2）37例肉芽肿病变，（3）15例错构瘤和（4）23例其他类型病变，其SUVmax常规分别为（2.74±2.04）、（3.78±3.07）、（0.88±0.64）和（1.25±1.03）。常规扫描没有摄取、轻度摄取增高和明显摄取增高的肺结节分别为21、56和44例。炎症和肉芽肿结节多为轻度或明显摄取增高，错构瘤和其他类型良性结节多为没有摄取或轻度摄取增高（P＜0.01）。98例行延迟显像的结节，储留指数（RI）升高61例、不变或下降37例。炎症和肉芽肿结节行延迟扫描后的摄取多升高，而错构瘤延迟扫描后摄取多不变或下降（P＜0.01）。良性肺结节的摄取与大小呈正相关（P＜0.01）。结论 炎症和肉芽肿结节在18F-FDG PET-CT上多为轻度或明显摄取增高，需要与肺癌鉴别。而错构瘤和其他类型良性结节多为没有摄取或轻度摄取增高。对于摄取明显增高(SUVmax≥2.5)的肺结节行延迟显像无鉴别意义。
• Objective To analyze 18F-FDG PET-CT features of benign pulmonary nodules, and to improve the differential diagnosis of benign pulmonary nodules by 18F-FDG PET-CT. Methods One hundred and twenty-one patients with benign pulmonary nodules were studied retrospectively. Each patient underwent a 18F-FDG PET-CT scan. Ninety-eight patients underwent a dual-time-point PET-CT scan. All cases were proved by pathology or by diagnostic therapy or by follow-up. Results According to the final results, the benign pulmonary nodules were classified as(1) inflammatory nodules, (2)granulomas,(3) hamartomas or (4)the other benign pulmonary nodules. The routine SUVmax of inflammatory nodules, granulomas, hamartomas and the other benign pulmonary nodules were （2.74±2.04）、（3.78±3.07）、（0.88±0.64） and （1.25±1.03）, respectively. There were moderate or high FDG uptake in the majority of inflammatory nodules and granulomas, while no or mild uptake in the majority of hamartomas and the other benign pulmonary nodules(P＜0.01). The RIs were increased in 61 patients, and decreased or no changed in 37 patients. The RIs of the majority of inflammatory nodules and granulomas were increased, while the RIs of the majority of hamartomas were decreased or no changed （P＜0.01）. The SUVmax was correlated with the diameter of benign pulmonary nodules （P＜0.01）. Conclusion The majority of inflammatory nodules and granulomas show moderate or high FDG uptake on 18F-FDG PET-CT, while the majority of hamartomas and the other benign pulmonary nodules show no or mild uptake. The dual-time-point PET-CT scan is not helpful for the differential diagnosis if the lesions show high FDG uptake on routine scan.