Department of Radiology, The Second Hospital Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China.
Department of PET/CT Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, Shandong, China.
Contrast Media Mol Imaging. 2022 Feb 21;2022:8968855. doi: 10.1155/2022/8968855. eCollection 2022.
Solitary pulmonary intravascular metastasis is a rare complication of malignant tumors, and accurate diagnosis can improve clinical decision-making, but diagnosing it effectively using conventional techniques is difficult.
To explore the value of F-FDG PET/CT combined with lung high-resolution computed tomography (HRCT) in the diagnosis of solitary pulmonary intravascular metastasis.
F-FDG PET/CT, lung HRCT, and follow-up data of 18,143 cancer patients were retrospectively analyzed to select patients with pulmonary vessel involvement besides the primary tumor only. The histopathological or imaging follow-up results were used as the diagnostic criteria for pulmonary intravascular metastasis.
A total of 13 patients with 17 pulmonary intravascular metastases were found, of which 9 patients had a single lesion and 4 had double. The SUVmax was 1.1-5.4 (average, 2.4 ± 1.4), and the length of hypermetabolic metastasis was 5.1-24.1 mm (average, 10.7 ± 6.5 mm). All the intravascular metastases were located in the terminal pulmonary vessels. Strip or branched pulmonary vessels enlargement with increased metabolism was the main imaging manifestation (15/17, 88.2%), while the other 2 cases only showed strip metabolic enhancement without abnormalities in pulmonary vessels (2/17, 11.8%). Four pulmonary intravascular metastases were confirmed by pathology, and the other 13 cases were diagnosed by imaging follow-up.
F-FDG PET/CT combined with lung HRCT is an effective technique for the diagnosis of solitary pulmonary intravascular metastasis. High-strip or branched FDG uptake in the distal pulmonary vessel accompanied by corresponding morphological changes in patients with malignant tumors can be used as a specific diagnostic indicator.
孤立性肺血管内转移是恶性肿瘤的一种罕见并发症，准确的诊断可以改善临床决策，但使用常规技术有效地诊断它具有挑战性。
探讨 F-FDG PET/CT 联合肺部高分辨率 CT（HRCT）在孤立性肺血管内转移诊断中的价值。
回顾性分析了 18143 例癌症患者的 F-FDG PET/CT、肺部 HRCT 和随访资料，以选择仅原发性肿瘤以外的肺血管受累患者。将组织病理学或影像学随访结果作为肺血管内转移的诊断标准。
共发现 13 例 17 个肺血管内转移病灶，其中 9 例为单发，4 例为双发。SUVmax 为 1.1-5.4（平均 2.4±1.4），高代谢转移的长度为 5.1-24.1mm（平均 10.7±6.5mm）。所有的血管内转移均位于终末肺动脉内。主要的影像学表现为增粗的条索状或树枝状肺动脉伴代谢增高（15/17，88.2%），而另外 2 例仅表现为条索状代谢增强而肺动脉无异常（2/17，11.8%）。4 个肺血管内转移通过病理证实，其余 13 个病例通过影像学随访诊断。
F-FDG PET/CT 联合肺部 HRCT 是诊断孤立性肺血管内转移的有效方法。在恶性肿瘤患者中，远端肺血管呈高条状或树枝状摄取 FDG 并伴有相应的形态学改变可作为特异性诊断指标。
