【摘要】 目的探讨HRCT与PET/CT相结合对孤立性肺癌结节和结核球的鉴别诊断价值。方法回顾性分析经病理或临床证实的孤立性肺癌结节和结核球共60例,全部病例均行PET/CT显像和胸部HRCT检查。PET/CT用目测法结合半定量法判断良恶性,HRCT根据病灶的形态学特征判断良恶性,统计PET/CT诊断结果和HRCT与PET/CT相结合诊断结果。结果病理或临床证实的孤立性肺癌结节和结核球分别为38例和22例,单纯PET/CT正确诊断36例肺癌和14例结核球,2例肺癌PET/CT显像为阴性,其中1例经HRCT和PET/CT联合诊断为恶性;8例结核球PET/CT显像为阳性,其中7例经HRCT和PET/CT结合后正确诊断。单纯PET/CT诊断和联合诊断对孤立性肺癌结节和结核球鉴别的敏感性、特异性和准确性分别为94.74%、63.64%、83.33%和97.37%、95.45%、96.67%。结论 HRCT与PET/CT相结合能大大降低孤立性结核球良恶性判断的假阳性率,可明显提高孤立性肺癌结节和结核球的鉴别的准确性。更多还原

【Abstract】 Objective To evaluate the value of HRCT and PET/CT in differential diagnosis of solitary lung cancer from tuberculoma. Methods PET / CT and HRCT imaging of 60 patients with isolated lung cancer or tuberculoma confirmed by pathology or clinical follow-up were retrospectively analyzed. The diagnosis accuracy of PET / CT and combination of HRCT and PET / CT were respectively evaluated. Results 38 cases of solitary lung cancer and 22 cases of tuberculoma were confirmed by the pathological or clinical follow up. PET / CT correctly diagnosed 36 cases of lung cancer and 14 cases of tuberculoma. 2 cases of lung cancer showed negative on PET / CT imaging and 1 of them were correctly diagnosed by HRCT combined with PET / CT. in 8 cases of tuberculoma,all the lesions showed positive on PET / CT imaging and 7 lesions were correctly diagnosed by HRCT combined with PET / CT. The sensitivity,specificity and accuracy of diagnosing solitary lung cancer were 94. 74%,63. 64%,83. 33% by utilizing PET / CT singly and 97. 37%,95. 45%,96. 67% by HRCT combined with PET / CT. Conclusion HRCT combined with PET / CT can significantly improve the differential diagnosis of solitary lung cancer from tuberculoma.更多还原