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F-FDG PET/CT在肺错构瘤与肺类癌鉴别诊断中的作用

Contribution of F-FDG PET/CT in the Differential Diagnosis of Pulmonary Hamartomas and Pulmonary Carcinoids.

作者信息

Tatcı Ebru, Özmen Özlem, Öztürk Ayperi, Demirağ Funda

机构信息

University of Health Sciences Turkey, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Clinic of Nuclear Medicine, Ankara, Turkey

University of Health Sciences Turkey, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Clinic of Interventional Pulmonology, Ankara, Turkey

出版信息

Mol Imaging Radionucl Ther. 2021 Jun 3;30(2):101-106. doi: 10.4274/mirt.galenos.2021.20633.

Abstract

OBJECTIVES

This study aimed to evaluate fluorine-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) findings in the differential diagnosis of pulmonary carcinoids and pulmonary hamartomas.

METHODS

F-FDG PET/CT findings of 34 patients with pulmonary carcinoids (12 atypical, 22 typical) and 32 patients with pulmonary hamartomas were retrospectively evaluated. Both mean diameter and mean maximum standardized uptake value (SUV) of hamartomas and carcinoids were compared by Mann-Whitney U and Kruskall-Wallis H tests.

RESULTS

The mean longest diameter of atypical carcinoids (3.5±1.7 cm) was higher than that of hamartomas (2.1±1 cm) (p=0.038). No significant difference was found between the mean diameter of typical carcinoids and mean diameter of hamartomas (p=0.128). The mean SUV of atypical carcinoids (5.97±3.7) and typical carcinoids (4.22±1.7) were higher than those of hamartomas (1.65±0.9) (p=0.002 and p=0.003, respectively). There were collapse/consolidation in 55.8%, bronchiectasis or mucoid impaction in 47%, and air trapping in 14.7% in the peripheral parenchyma of the 34 carcinoids. Collapse/consolidation was detected in a patient with endobronchial hamartoma, and other finding was not found in the parenchyma around hamartomas.

CONCLUSION

The F-FDG uptake of pulmonary carcinoids can vary from minimal to intense. F-FDG uptake can be seen in pulmonary hamartomas. However, the mean SUV of atypical carcinoids and typical carcinoids were higher compared to hamartomas. Pulmonary carcinoid must be suspected in cases with accompanying bronchial obstruction findings in the periphery of the mass.

摘要

目的

本研究旨在评估氟代脱氧葡萄糖(F-FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)在肺类癌和肺错构瘤鉴别诊断中的表现。

方法

回顾性分析34例肺类癌患者(12例不典型,22例典型)和32例肺错构瘤患者的F-FDG PET/CT表现。采用Mann-Whitney U检验和Kruskall-Wallis H检验比较错构瘤和类癌的平均直径及平均最大标准化摄取值(SUV)。

结果

不典型类癌的平均最长径(3.5±1.7 cm)高于错构瘤(2.1±1 cm)(p=0.038)。典型类癌的平均直径与错构瘤的平均直径之间无显著差异(p=0.128)。不典型类癌(5.97±3.7)和典型类癌(4.22±1.7)的平均SUV高于错构瘤(1.65±0.9)(分别为p=0.002和p=0.003)。34例类癌的外周实质中,55.8%出现肺不张/实变,47%出现支气管扩张或黏液嵌塞,14.7%出现空气潴留。1例支气管内错构瘤患者出现肺不张/实变,错构瘤周围实质未发现其他异常表现。

结论

肺类癌的F-FDG摄取可从轻微到强烈不等。肺错构瘤中也可见F-FDG摄取。然而,与错构瘤相比,不典型类癌和典型类癌的平均SUV更高。对于肿块周围伴有支气管阻塞表现的病例,必须怀疑肺类癌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e41d/8185474/697e5ded85bb/MIRT-30-101-g1.jpg

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