隋玉栋, 王清, 高山, 郭兴隆, 路月, 林帅, 张静, 王艳丽. 增强CT联合18F-FDG PET/CT在肺隔离症诊断中的应用及其图像特征分析[J]. 国际放射医学核医学杂志. DOI: 10.3760/cma.j.cn121381-202211020-00395
引用本文: 隋玉栋, 王清, 高山, 郭兴隆, 路月, 林帅, 张静, 王艳丽. 增强CT联合18F-FDG PET/CT在肺隔离症诊断中的应用及其图像特征分析[J]. 国际放射医学核医学杂志. DOI: 10.3760/cma.j.cn121381-202211020-00395
Yudong Sui, Qing Wang, Shan Gao, Xinglong Guo, Yue Lu, Shuai Lin, Jing Zhang, Yanli Wang. Application and image feature analysis of enhanced CT combined with 18F-FDG PET/CT in diagnosis of pulmonary sequestration[J]. Int J Radiat Med Nucl Med. DOI: 10.3760/cma.j.cn121381-202211020-00395
Citation: Yudong Sui, Qing Wang, Shan Gao, Xinglong Guo, Yue Lu, Shuai Lin, Jing Zhang, Yanli Wang. Application and image feature analysis of enhanced CT combined with 18F-FDG PET/CT in diagnosis of pulmonary sequestration[J]. Int J Radiat Med Nucl Med. DOI: 10.3760/cma.j.cn121381-202211020-00395

增强CT联合18F-FDG PET/CT在肺隔离症诊断中的应用及其图像特征分析

Application and image feature analysis of enhanced CT combined with 18F-FDG PET/CT in diagnosis of pulmonary sequestration

  • 摘要:
    目的 探讨增强CT联合18F-FDG PET/CT在肺隔离症(PS)诊断中的应用并对其图像特征进行分析。
    方法 回顾性分析2007年10月至2020年12月于青岛大学附属青岛市中心医院经手术证实伴有肿瘤标志物水平升高的6例PS患者的临床资料,其中男性2例、女性4例,年龄(49.8±17.5)岁。6例患者均行18F-FDG PET/CT显像及增强CT扫描,观察病变位置、形态、密度、CT强化特点及18F-FDG代谢情况。
    结果 6例患者的病灶均位于肺下叶后基底段,其中右肺4例、左肺2例。病灶最大径为(4.3±2.0) cm,平扫CT值为(27.2±13.9) HU。病灶形态呈椭圆形、类圆形、类三角形的患者各2例;1例患者的病灶内可见钙化灶。1例患者的CT图像呈明显强化,4例呈中度强化,1例无明显强化。6例患者均发现了起自胸主动脉的异常供血动脉。囊性肿块型患者2例,实性肿块型患者3例,囊实性肿块型患者1例。局部肺叶内血管增多、增粗、紊乱患者3例。18F-FDG代谢中度增高患者2例、轻度增高患者3例、无代谢增高患者1例。
    结论 当患者有不同程度的肿瘤标志物水平升高,双肺下叶脊柱旁发现类圆形、椭圆形、类三角形结节或肿块,18F-FDG代谢增高且CT增强扫描发现异常供血动脉并伴轻到中度强化或病灶无18F-FDG代谢增高且CT增强扫描无明显强化但发现异常供血动脉时,均要考虑PS的可能性。CT增强联合18F-FDG PET/CT显像可以提高PS诊断的准确性。

     

    Abstract:
    Objective To explore the application of enhanced CT combined with 18F-FDG PET/CT in the diagnosis of pulmonary sequestration (PS) and analyze the image characteristics.
    Methods The clinical data of 6 patients with PS, including 2 males and 4 females, aged (49.8±17.5) years, who were surgically confirmed to be accompanied by elevated levels of tumor markers at the Affiliated Qingdao Central Hospital of Qingdao University from October 2007 to December 2020 were retrospectively analyzed.18F-FDG PET/CT imaging and enhanced CT scanning were performed in the 6 patients, and the location of the lesions, morphology, density, CT enhancement characteristics and 18F-FDG metabolism were observed.
    Results The lesions in the six patients were all located in the posterior basal segment of the lower lobe of the lung, including four cases in the right lung and two cases in the left lung. The maximum diameter of the lesion was (4.3±2.0) cm, and the CT value on plain scan was (27.2±13.9) HU. 2 patients had oval, rounded, or triangular-shaped lesions, and 1 patient had calcified foci within the lesion; 1 patient had marked enhancement on the CT image, 4 had moderate enhancement, and 1 had no marked enhancement. 6 patients were found to have an abnormal arterial blood supply originating from the thoracic aorta. Two patients had cystic masses, three patients had solid masses, and one patient had a cystic-solid mass. There were 3 patients with localized vascularization, coarsening, and disorganization in the lobes of the lungs, 2 patients with moderately increased 18F-FDG metabolism, 3 patients with mildly increased metabolism, and 1 patient with no metabolism increased metabolism.
    Conclusion The possibility of PS should be considered when patients have different degrees of elevated levels of tumour markers, round-like, oval-like, triangular-like nodules or masses found adjacent to the spine in the lower lobes of both lungs, increased 18F-FDG metabolism and abnormal blood-supplying arteries detected on CT-enhanced scans with mild-to-moderate enhancement, or when the lesion has no increased 18F-FDG metabolism and there is no significant enhancement on CT-enhanced scans, but abnormal blood-supplying arteries were detected. CT enhancement combined with 18F-FDG PET/CT imaging improves the accuracy of PS diagnosis.

     

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