【摘要】 目的分析18F-FDG PET/CT显像在非小细胞肺癌纵隔淋巴结转移与老年非特异性淋巴结高摄取的特点,以提高诊断准确性。资料与方法回顾性分析经18F-FDG PET/CT检查发现纵隔淋巴结摄取增高的127例非小细胞肺癌患者,包括纵隔淋巴结转移58例共161个淋巴结和老年非特异性淋巴结摄取69例共160个淋巴结,均经病理或随访结果证实,分析肺癌淋巴结转移与老年非特异性淋巴结高摄取的特点。结果肺癌纵隔淋巴结转移病灶长径较大,为(2.22±1.00)cm,其代谢较高,分布无明显规律,59个分布在4区,31个分布在7区;老年非特异性淋巴结分布有一定的规律,主要表现为在纵隔及肺门部位呈对称性分布,淋巴结长径较小,为(1.37±0.48)cm,密度较高,PET图像伴轻度异常高代谢。肺癌纵隔淋巴结转移长径及SUVmax(7.45±4.49)均显著大于老年非特异性淋巴结(SUVmax 3.94±1.36)(t=-7.50、-7.37,P<0.01),CT值为(30.73±4.31)Hu,显著小于老年非特异性淋巴结的(81.27±14.24)Hu(t=-24.47,P<0.01)。结论 18F-FDG PET/CT显像依据纵隔淋巴结的分布特征、大小、密度及代谢情况能够鉴别诊断非小细胞肺癌纵隔淋巴结转移与老年非特异性淋巴结,有利于做出正确的临床诊断。更多还原

【Abstract】 Purpose To improve the diagnostic accuracy by analyzing the features of 18F-FDG PET/CT imaging in non-small cell lung cancer with mediastinal lymph node metastasis and nonspecific high uptake of lymph node in elderly.Materials and Methods For 127 non-small cell lung cancer patients with mediastinal lymph node increased uptake revealed in 18F-FDG PET/CT examination were retrospective analyzed,including mediastinal lymph node metastasis in 58 cases with 161 lymph nodes and non-specific lymph node uptake in elderly in 69 cases with 160 lymph nodes,the diagnosis was confirmed by pathology or follow-up results,and the characteristics of lung cancer lymph node metastasis and nonspecific lymphatic high uptake in elderly was analyzed.Results Diameter of mediastinal lymph node metastases was larger(2.22±1.00) cm,with higher metabolism and no obvious pattern in its distribution,59 of them located in district 4 and 31 located in district 7;while there was certain pattern for the distribution of non-specific lymph nodes in elderly,mainly as symmetric distribution in mediastinal and hilar,with smaller diameter(1.37±0.48) cm,higher density,and mild unusually high metabolism in PET images.Lymph node diameter and SUVmax(7.45±4.49) in mediastinal metastasis were significantly higher than those of the non-specific lymph nodes in elderly which were(1.37±0.48) cm and 3.94±1.36(t=-7.50 and-7.37,P<0.01),but CT value of the mediastinal metastasis lymph nodes(30.73±4.31) Hu was significantly less than that of the elderly non-specific lymph nodes(81.27±14.24) Hu(t=- 24.47,P<0.01).Conclusion According to the distribution pattern,size,density and metabolism of mediastinal lymph nodes in 18F-FDG PET/CT imaging,non-small cell lung cancer with mediastinal lymph node metastasis and non-specific lymph nodes in elderly can be distinguished,which is beneficial to make the correct clinical diagnosis.更多还原