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目的:探讨18F-FDG PET/CT显像诊断肺癌的价值。方法:对2006年10月～2009年1月经病理证实的115例肺癌和53例肺良性病变的PET/CT显像进行回顾性分析。分别观察肺部病灶的CT形态及PET显像的FDG最大标准摄取值(SUVmax);结合临床、病理诊断及治疗资料,分析PET、CT、PET/CT对肺癌原发灶及转移灶诊断的灵敏度、特异性及准确性。结果:CT对168例肺部病变患者诊断的灵敏度、特异性和准确性分别为73.9%(85/115)、73.6%(39/53)、73.8%(124/168);PET分别为82.6%(95/115)、62.3%(33/53)、76.2%(128/168);PET/CT分别为90.4%(104/115)、81.1%(43/53)、87.5%(147/168)。55例行肺癌根治术患者中纵隔、肺门淋巴结转移31例,PET诊断肺癌纵隔、肺门淋巴结转移的灵敏度、特异性及准确性分别为70.9%、95.8%、81.8%;CT分别为41.9%、87.5%、65.5%;PET/CT分别为90.3%、95.8%、92.7%。肺癌远处转移41例,PET/CT发现105处骨转移,单纯CT只发现25处。结论:PET/CT对肺癌原发灶及转移灶较单纯PET、单纯CT的诊断灵敏度、特异性及准确性高,在肺癌的诊断和分期中具有较高的应用价值。
Objective: To investigate the value of 18F-FDG PET / CT in the diagnosis of lung cancer. Methods: The clinical data of 115 patients with lung cancer and 53 patients with benign lung disease confirmed by pathology from October 2006 to January 2009 were analyzed retrospectively. To observe the CT features of lung lesions and the maximum FDG uptake value (FDG) for PET imaging respectively. The sensitivity of PET, CT and PET / CT in the diagnosis of primary lung cancer and metastasis was analyzed based on clinical, pathological diagnosis and treatment data , Specificity and accuracy. Results: The sensitivity, specificity and accuracy of CT in diagnosing 168 cases of lung disease were 73.9% (85/115), 73.6% (39/53) and 73.8% (124/168), respectively. The PET was 82.6% PET / CT were 90.4% (104/115), 81.1% (43/53), 87.5% (147/168), respectively. . The sensitivity, specificity and accuracy of PET in diagnosis of mediastinal and hilar lymphatic metastasis of lung cancer were 70.9%, 95.8% and 81.8% respectively in 55 patients with radical resection of lung cancer and in 31 cases of metastasis of mediastinal and hilar lymph nodes. The CT was 41.9% , 87.5% and 65.5% respectively; PET / CT were 90.3%, 95.8% and 92.7% respectively. Forty-one patients were distantly metastasized from lung cancer, 105 were found to be metastatic to bone by PET / CT, and 25 were found only by CT. Conclusion: The sensitivity, specificity and accuracy of PET / CT in the diagnosis and metastasis of primary lung cancer are higher than those of simple PET and simple CT. It is of great value in the diagnosis and staging of lung cancer.