摘要
目的:总结分析18F-脱氧葡萄糖(FDG)PET-CT对肺部良性病变的误诊原因,提高对良性病变形态学特征及显像特点的认识。方法:回顾性分析PET-CT误诊为恶性病变的33例肺部良性病变的PET-CT影像资料,对病灶大小、分布、边缘、密度、周围伴随征象等CT表现进行分析,统计良性病变放射性浓聚的病例数,并对不同病理类型病变的SUVmax进行比较。结果:结核易发生于上叶尖后段(10/23)及下叶背段(5/23),真菌感染好发于下叶(3/3)。毛刺(15/33)及分叶征(12/33)常见,其中毛刺在炎性病变中多见(4/4),晕征在真菌感染中多见(3/3);胸膜牵拉是常见的伴随征象(7/33)。结核、真菌感染、良性肿瘤、炎性病变各组平均SUVmax依次为5.54±4.18、4.63±1.28、6.23±1.32、2.07±1.44,组间差异无统计学意义(F=2.36,P=0.064),其中25例发生18 F-FDG放射性浓聚,包括结核18例,真菌感染及良性肿瘤各3例,炎性病变1例。在误诊的33例良性病例中,18例因具有恶性CT征象同时SUVmax≥2.5而作出诊断;8例仅因具有恶性CT征象而作出诊断;7例不具备典型的恶性CT征象,仅因SUVmax≥2.5作出诊断。结论:肺结核是最易误诊的肺部良性病变,误诊原因与不典型CT征象及FDG高代谢有关;正确认识不同性质良性病变的好发部位、特征性CT征象及放射性摄取特点对减少误诊有一定帮助。
Objective：In order to reduce false positive results,the misdiagnosed cases of pulmonary benign lesions by is F-fluorodeoxyglucose （FDG） PET/CT imaging were retrospective analyzed. Methods：CT appearance of 33 cases with clinically proved pulmonary benign lesions was retrospectively reviewed, including the lesion size, distribution, edges, density and associated findings. PET images were evaluated with standardized uptake value（SUV）and radioactivity distribution. SU-Vmax in lesions of different types of pathology were compared. Results：Tuberculoma was most frequently located in apicoposterior segment of the upper lobe（10/23）and posterior segment of the lower 1ohe（5/23） , and pulmonary fungal disease mostly in the upper lobe（3/3）. Spicule （15/33）and lobulation（12/33）were common. Spicule occurred in all inflammatory le- sions,and halo sign occurred in all pulmonary fungal diseases. Pleural retraction was common associated findings（7/33）. High uptake of 18F-FDG occurred in 25 cases, including 18 cases of tuberculoma,3 cases of fungal disease and benign tumor respectively, and 1 case of inflammatory lesion, SUVmax of which was 5.54 ± 4.18,4.63 ±1.28,6.23± 1.32,2.07 ±1.44 respectively. There was no significant difference in the above 4 groups. 18/33 were falsely diagnosed because both of CT ap- pearance and high uptake in 18 F-FDG,8/33 because of CT appearance, and 7/33 because of high uptake in 18 F-FDG. Conclusion..Tuberculoma is the most common misdiagnosed pulmonary benign lesion in our study. It is helpful for reduce false diagnosis of benign lesions by analyzing predilection site and CT appearance as well as radioactive uptake of every case.
出处
《放射学实践》
2014年第5期541-544,共4页
Radiologic Practice
关键词
误诊
脱氧葡萄糖
体层摄影术
发射型计算机
X线计算机
Diagnostic errors
Deoxyglucose
Tomography,emission-computed
Tomography,X-ray computed
