知识与财富的链接
目的 探讨PET/CT诊断肺癌的价值.方法 104例患者,34例经病理结果证实,70例为临床诊断.18F- FDG的合成由GE MINITrace 和TracerLab FX-fn采用全自动化学方法合成,PET/CT为GE discovery ST.18F-FDG注射剂量为0.1 mCi/kg,注药后50 min后3 min/床位进行2D扫描,扫描范围头部至腹股沟下.结果 104例患者,86例最后诊断为肺癌,25例肺癌PET/CT上未见任何转移,12例患者做了肺叶切除手术,4例手术后病理发现纵隔肺门淋巴结转移,其中2例PET/CT为真阳性.PET/CT共发现33例肺癌有远处转移,其中有30例出现多发骨转移、4例伴肝转移,4例伴脑转移、1例伴肾上腺转移,而在30例骨转移中,单纯CT只发现了9例,即使在这9例患者,CT发现骨转移的部位也远远少于PET/CT,另外有5例ECT发现骨浓聚怀疑骨转移的肺癌患者,PET/CT检查发现肋骨或脊椎陈旧性骨折而排除骨转移;良性病变18例中结核4例,炎症5例(1例肺脓肿),其余9例定期观察无变化.恶性病变组标准摄取值(SUV)平均为7.00±3.82,良性病变组SUV平均值为3.27±1.77,二者SUV差异有显著性(P＜0.01),而肺癌恶性无转移与有转移组间的SUV差异无显著性(P＞0.05).结论 PET/CT诊断肺部病变的灵敏性为97.7%,特异性为94.1%,准确性为97.9%,明显高于单纯PET或单纯CT的诊断的准确率.另外,PET/CT在发现并确定肺癌转移灶上有很高的准确性.
Objective To evaluate the value of PET/CT in diagnosis of lung neoplasms. Methods Total 104 patients, 34 had pathological diagnosis, the others were clinical diagnosis. GE MINITrace and TracerLab Fx-fn were used to automatically produce 18F-FDG. GE discovery ST was PET/CT scanner. Injection dose was 0.1 mCi/kg, 2D acquisition after 50 min injection, 3 min/bed, general scan range. Results Eighty-six of 104 patients were lung cancer, 25 of them had no metastasis in PET/CT, 12 of them had operation, 4 of 12 who had done operation had mediastinal and hilar lymph node metastasis by pathology, 2 of these 4 PET/CT results were true positive. Total 33 patients had metastasis, 30 of them had bone metastasis, 4 had liver metastasis, 4 had brain metastasis, and 1 adrenal metastasis. In 30 bone metastasis patients, only 9 cases were found by CT, and the lesions found by CT were less than by PET/CT. Five patients which were suspect metastasis in SPECT were found aged fracture. Eighteen of 104 patients were benign lesions, 4 TB, 5 inflammation, and the rest of them have no progress in regular inspection. The average standardized uptake value (SUV) of malignant lesions was 7.00±3.82, the average SUV of benign was 7.00±3.82, two results had significant difference (P<0.01), no specific difference of average SUV can be found in lung cancer with/without metastasis (P>0.05). Conclusion PET/CT has 97.7% of sensitivity, 94.1% of specificity and 97.9% of accuracy in diagnosis of lung neoplasms, which are obviously higher than PET or CT lonely. PET/CT also has good accuracy in metastasis detection of lung cancer.
