摘要
目的:比较分析肺孤立性占位^(18)F-FDG PET/CT图像中CT形态特征对PET代谢特征的影响。材料和方法:回顾性收集211例完成全身^(18)F-FDG PET/CT显像的肺孤立性占位患者,所有患者均经病理证实或影像学随访一年以上。在CT图像中分析每个病灶的大小、分叶征、毛刺征和胸膜牵拉征等形态特征,在PET图像中获取每个病灶的平均标准摄取值(SUVave)等代谢特征。所有特征均与病理和临床随访结果相比较。结果:211例肺孤立性占位患者中恶性占位163例,良性占位48例。以SUVave=2.5作为良恶性鉴别的定量依据,^(18)F-FDG PET对肺孤立性占位的诊断灵敏度、特异性及准确性分别为86.5%,52.1%和78.7%。163例恶性占位中,57例>3cm的恶性占位,其SUVave明显高于106例≤3cm的病灶(6.84±2.06比4.13±2.42,P<0.01);116例具有分叶特征的恶性病灶SUVave明显高于47例无分叶特征的恶性病灶(5.45±2.40比4.25±2.86,P<0.01)。106例≤3cm的恶性占位(肺孤立性结节),具有分叶、毛刺征的SUVave明显高于无毛刺征的恶性占位(4.70±2.41比3.30±2.20;4.55±2.20比3.58±2.59,P均<0.01)。胸膜牵拉征对SUVave的影响没有差异。结论:^(18)F-FDG PET显像可以较好的鉴别诊断肺内孤立性占位。肿瘤大小、分叶对恶性肿瘤代谢特征均有明显影响;毛刺征对恶性肿瘤代谢特征的影响主要体现在肺孤立性结节中,胸膜牵拉征对代谢特征影响不明显。
Objective： The purpose of this study is to explore the relationship between the morphologic features of CT and metabolism characterization of PET in the solitary pulmonary lesion. Methods： Two hundred and eleven patients with solitary Pulmonary lesion underwent whole ^ 18F - FDG PET/ CT imaging. Semiquantitative parameters of ^ 18F - FDG uptake（SUVave） and morphologic features of CT including lobulated, spicular sign and pleural indentation were analyzed. Results were compared with pathologic examination and clinical followup. Results： There were 163 malignant and 48 benign lesions. Based on the SUV and a cut - off value of 〉 2.5, PET/CT has a sensitivity of 86.5%, specificity of 52. 196, diagnostic accuracy of 78.7%. The SUVave of 57 malignant lesions more than 3cm in size is more greater than 106 malignant lesions less than 3cm（6.84 ± 2.06 vs 4.13 ± 2.42, P 〈 0.01） ; 116 malignant lesions with lobulated is greater than no lobulated lesions（5.45 ± 2.40 vs 4.25 ± 2.86, P 〈 0.01） . For 106 malignant lesions of less than 3cm, SUVmean of malignant lesion with lobulated and spicular signs is greater than not（ 4.70 ± 2.41vs3.30 ± 2.20; 4.55 ± 2.20vs3.58 ± 2.59, P 〈 0.01） ; there is no different between the lesions with pleural indentation and no -pleural indentation lesions. Conclusion： PET/CT allows accurate analysis of morphological and metabolic correlations of solitary pulmonary lesion, providing useful data for differentiating between malignant and benign lesions. There is obvious relation between morphologic features of CT and metabolism characterization of PET.
出处
《中国医学计算机成像杂志》
CSCD
2008年第4期355-360,共6页
Chinese Computed Medical Imaging
基金
上海市科委重点基金(04JC14044)
上海市百人计划(97BR012)~~
