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PET/CT与MRI在同步性多发肺磨玻璃结节患者诊治中的应用价值

Application Value of PET/CT and MRI in the Diagnosis and Treatment of Patients With Synchronous Multiple Pulmonary Ground-Glass Nodules.

作者信息

Xie Shaonan, Li Shaoteng, Deng Huiyan, Han Yaqing, Liu Guangjie, Liu Qingyi

机构信息

Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.

Department of Diagnostic Radiology, The People's Hospital of Xingtai, Xingtai, China.

出版信息

Front Oncol. 2022 Feb 23;12:797823. doi: 10.3389/fonc.2022.797823. eCollection 2022.

Abstract

BACKGROUND

Synchronous multiple ground-glass nodules (SMGGNs) in synchronous multiple lung cancers are associated with specific imaging findings. It is difficult to distinguish whether multiple nodules are primary tumors or metastatic lesions in the lungs. The need for PET/CT and contrast-enhanced brain MRI for these patients remains unclear. This study investigated the necessity of these two imaging examinations for SMGGN patients by means of retrospective analysis.

METHODS

SMGGN patients who were diagnosed and treated in our hospital from October 2017 to May 2020 and underwent whole-body PET/CT(Cranial excepted) and/or contrast-enhanced brain MRI+DWI were enrolled in this study. We analyzed the imaging and clinical characteristics of these patients to evaluate SMGGN patients' need to undergo whole-body PET/CT and brain MRI examination.

RESULTS

A total of 87 SMGGN patients were enrolled. 51 patients underwent whole-body PET/CT examinations and did not show signs of primary tumors in other organs, metastatic foci in other organs, or metastasis to surrounding lymph nodes. 87 patients underwent whole-brain MRI, which did not reveal brain metastases but did detect an old cerebral infarction in 23 patients and a new cerebral infarction in one patient. 87 patients underwent surgical treatment in which 219 nodules were removed. All nodules were diagnosed as adenocarcinoma or atypical adenomatous hyperplasia. No lymph node metastasis was noted.

CONCLUSION

For SMGGN patients, PET/CT and enhanced cranial MRI are unnecessary for SMGGNs patients, but from the perspective of perioperative patient safety, preoperative MRI+DWI examination is recommended for SMGGNs patients.

摘要

背景

同步性多原发性肺癌中的同步性多个磨玻璃结节(SMGGN)具有特定的影像学表现。很难区分多个结节是肺部的原发性肿瘤还是转移性病变。对于这些患者,是否需要进行PET/CT和对比增强脑MRI检查仍不明确。本研究通过回顾性分析探讨了这两种影像学检查对SMGGN患者的必要性。

方法

本研究纳入了2017年10月至2020年5月在我院诊断并接受治疗、且接受了全身PET/CT(不包括头颅)和/或对比增强脑MRI+DWI检查的SMGGN患者。我们分析了这些患者的影像学和临床特征,以评估SMGGN患者进行全身PET/CT和脑MRI检查的必要性。

结果

共纳入87例SMGGN患者。51例患者接受了全身PET/CT检查,未显示其他器官有原发性肿瘤迹象、其他器官有转移灶或周围淋巴结转移。87例患者接受了全脑MRI检查,未发现脑转移,但在23例患者中检测到陈旧性脑梗死,1例患者中检测到新发脑梗死。87例患者接受了手术治疗,共切除219个结节。所有结节均诊断为腺癌或非典型腺瘤样增生。未发现淋巴结转移。

结论

对于SMGGN患者,PET/CT和增强头颅MRI并非必要,但从围手术期患者安全的角度考虑,建议SMGGN患者术前行MRI+DWI检查。

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