【摘要】 目的评价18F脱氧葡萄糖(FDG)符合线路显像(DHTC)寻找CT未能发现原发灶的胸腔积液或肺不张患者的肺癌原发灶,及其对肺癌伴有胸腔积液的患者胸腔积液良恶性鉴别诊断的价值。方法110例CT未发现肺部原发病灶但疑为肺癌及肺癌转移可能的胸腔积液或肺不张患者(其中胸腔积液84例,肺不张26例),进行18FFDGDHTC检查。结果38例患者最终确诊为肺癌,其中伴有胸腔积液30例,伴有肺不张8例;另72例为肺部良性病变。18FFDGDHTC对CT未能找到原发灶的胸腔积液或肺不张患者肺癌诊断的灵敏度、特异性和准确性分别为97%、78%和85%。30例伴有胸腔积液的肺癌患者中,21例确诊为恶性胸腔积液。18FFDGDHTC对良恶性胸腔积液鉴别诊断的灵敏度为86%,特异性为89例。结论18FFDGDHTC是寻找胸腔积液或肺不张患者肺癌原发灶灵敏可靠的方法,并对良恶性胸腔积液的鉴别诊断有一定的临床价值。更多还原

【Abstract】 Objective To determine the ability of ~18 F-fluorodeoxyglucose (FDG) dual-head tomography with coincidence (DHTC) imaging in detecting lung cancer in patients with suspected malignant pleural effusion or malignant atelectasis on CT scanning and to differentiate benign and malignant pleural effusions in patients with lung cancer. Methods One hundred and ten patients with suspected malignant pleural effusion (n=84) or atelectasis (n=26) but without primary lesions in the lungs on CT scanning underwent ~18 F-FDG DHTC. Results Thirty-eight of 110 patients were proven with lung cancer. Among the 38 lung cancer patients, 30 of them had pleural effusion and 8 of them had atelectasis. Seventy-two of 110 patients were proven with benign lung diseases. The sensitivity, specificity and accuracy of ~18 F-FDG DHTC for detecting lung cancer in patients with suspected malignant pleural effusion or atelectasis were 97%, 78% and 85%, respectively. In 30 patients with lung cancer plus pleural effusion, ~18 F-FDG DHTC correctly detected the presence of malignant pleural effusion and malignant pleural metastatic involvement in 18 of 21 patients and excluded malignant pleural effusion or pleural metastatic involvement in 8 of 9 patients (sensitivity, specificity and accuracy of 86%, 8/9 and 87%, respectively). Conclusion ~18 F-FDG DHTC imaging is a highly accurate and reliable noninvasive test for detecting primary malignant lesions in lung in patients with pleural effusion or atelectasis findings on CT scanning and is useful to differentiate malignant from benign pleural effusion in patients with lung cancer.更多还原