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目的:探讨以18F-FDG为代谢示踪剂的单光子发射型计算机断层(single photon emission computer tomographic,SPECT)进行符合线路显像(符合线路断层显像)对肺部肿块的诊断价值。方法:106例患者全部取得病理诊断,恶性肿瘤84例,良性肿块22例。将患者的胸部符合线路断层显像和CT的检查结论与病理结果进行比较。结果:符合线路断层显像诊断恶性肿瘤90例,良性肿块16例,其中假阳性9例,假阴性3例;胸部CT诊断恶性肿瘤86例,良性肿块20例,其中假阳性13例,假阴性11例。统计分析显示,对于诊断的敏感性、准确率和阴性预测值,二者间的差异有显著性,前者优于后者。结核是引起假阳性的主要病种,符合线路断层显像误判的9例中,6例为结核。引起误判的结核的病理形态通常表现为以增生为主的结节样病灶。结论:符合线路断层显像对肺部肿块的定性诊断具有较高的实用价值,对治疗方案的制订有指导意义。
OBJECTIVE: To investigate the diagnostic value of line photocoagulation (line tomography) in the diagnosis of pulmonary masses using single photon emission computed tomography (SPECT) with 18F-FDG as a metabolic tracer. Methods: All the 106 patients were pathologically diagnosed, including 84 malignant tumors and 22 benign tumors. The patient’s chest line tomography and CT findings and pathological findings were compared. Results: 90 cases were diagnosed as malignant tumors by line tomography and 16 cases were benign tumors, including 9 cases of false positives and 3 cases of false negatives. There were 86 cases of malignant tumors in chest CT and 20 cases of benign tumors, of which 13 were false positives and false negatives 11 cases. Statistical analysis showed that for the diagnosis of sensitivity, accuracy and negative predictive value, the difference was significant, the former is better than the latter. Tuberculosis is the main cause of false-positive disease, consistent with misjudgment of line tomography in 9 cases, 6 cases of tuberculosis. Misdiagnosed tuberculosis pathological morphology is usually manifested as hyperplasia-based nodular lesions. Conclusion: Computed tomography is of high practical value for the qualitative diagnosis of pulmonary masses, which is instructive for the formulation of treatment plans.