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18F-FDG PET/CT在肿瘤诊断、分期、疗效监测等方面具有很大的价值。18F-FDG PET/CT是根据18F-FDG在细胞中的代谢水平来显示病灶,并不是肿瘤的特异性显像剂,代谢旺盛的炎性细胞(如巨噬细胞、淋巴细胞、嗜酸性粒细胞等)也可表现为18F-FDG高摄取。病理上以肉芽肿形成为基本特征的炎症称为肉芽肿性炎。随着我国工业化的进程,肺肉芽肿性炎发病率越来越高,如肺结核、肺真菌病等。因此,在肺癌18F-FDG PET/CT显像时常常造成假阳性,导致误诊[1]。为了克服18F-FDG PET/CT显像的不足,许多研究者做了有益的探索,如联合显像、多模式显像、多时相显像等。本文就肺肉芽肿性炎的正电子核素显像表现、机制等方面进行综述,以期提高PET/CT在肺肿瘤鉴别诊断中的准确率。
肺肉芽肿性炎正电子核素显像机制与影像特征
Mechanism and performance of position radionulide imaging in lung granuloma
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摘要: 18F-FDG PET/CT在临床肿瘤诊断中被广泛应用,在鉴别肺良恶性病变中有较大价值。但是18F-FDG并非恶性肿瘤的特异性显像剂,代谢旺盛的炎性细胞(如巨噬细胞、淋巴细胞、嗜酸性粒细胞等)也可表现为18F-FDG高摄取。肺肉芽肿性炎的病理特点主要表现为大量代谢旺盛的炎性细胞浸润,所以肺肉芽肿性炎是导致18F-FDG PET/CT假阳性的主要病变。笔者就肺肉芽肿性炎的PET/CT表现、机制等方面进行综述,以提高PET/CT在肺部肿瘤鉴别诊断中的准确率。
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关键词:
- 肺 /
- 肉芽肿 /
- 正电子发射断层显像术 /
- 体层摄影术, X线计算机 /
- 假阳性
Abstract: 18F-FDG PET/CT has been widely used to diagnose benign and malignant lung tumors. 18F-FDG is not a targeted tumor malignancy indicator because highly metabolic inflammatory cells, such as macrophages, lymphocytes, and eosinophils, also exhibit high 18F-FDG uptake. Granulomatous lung inflammation is pathologically characterized by a large amount of metabolic inflammatory cell infiltration and is therefore the leading cause of false positive 18F-FDG PET/CT uptake. This review aims to improve the accuracy of 18F-FDG PET/CT technique in lung tumor diagnosis and help readers understand PET/CT technique and the mechanism of granulomatous lung inflammation.-
Key words:
- Lung /
- Granuloma /
- Positron-emission tomography /
- Tomography, X-ray computed /
- False positives
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