摘要目的 了解肺结核球的18F-脱氧葡萄糖(18F-FDG)符合线路断层的显像特点,以期为肺内孤立结节的鉴别诊断提供依据.方法 回顾性分析经临床明确诊断的27例患者共29个肺内结核球病灶的18F-FDG三探头符合线路断层显像的特点.采用目测分级法分析病灶的葡萄糖摄取程度,并将肺结核球病灶18F-FDG摄取程度分为3组(0级、1～2级、3～4级),观察其与病灶密度的关系.结果 共记录29个病灶.三维图像目测分级:0级10个,与其相对应的断面图像呈局限放射性缺损者7个,无异常放射性改变者3个;1～2级11个,3级5个,4级3个.设0～2级为阴性诊断标准,假阳性率为8/29.结核球目测分级随病灶内软组织密度增加而升高,差异均有统计学意义(x2为13.29～18.02,均P＜0.01).结论 肺结核球18F-FDG摄取程度随病灶内软组织比例的增加而升高.大部分结核球为低葡萄糖代谢,其中局部放射性缺损有特异性,结合CT图像进行综合分析,有助于与肺内恶性病变鉴别.

abstractsObjective To assess the uptake of Fluorodeoxyglucose F18 (18F-FDG) coincidence single photon emission computed tomography (SPECT) imaging in lung tuberculoma. Methods We enrolled 27 cases with 29 tuberculomas confirmed by clinical diagnosis. 18F-FDG triple-head coincidence imaging was performed. The intensity of uptake was graded by visual method and the relationgship of the uptake and attenuation was analyzed. Results The uptake of 18F-FDG was graded by visual method. There were 10 lesions (34. 5% ) in grade 0, including 7 (24. 1% ) lesions that showed focal lack of uptake and 3( 10. 3% ) lesions showed normal uptake in tomograph imaging. Eleven lesions (37.9% ) were graded as 1-2,5 lesions (17. 2% ) as 3, and 3 lesions as 4. With grade 0-2 being regarded as benign, the false positive rate was 8/29. The intensity of18 F-FDG uptake was divided into 3 groups ( grade 0, grade 1 - 2, grade 3 -4) and the intensity of uptake was compared with the attenuation of tuberculomas. There was a statistically significant difference among the 3 groups (χ2 = 13. 29 - 18.02, P < 0. 01). Conclusions The intensity of 18 F-FDG uptake was influenced by the attenuation of the lesion. Most lung tuberculomas for 18F- FDG coincidence imaging were of low uptake, and lower uptake than the background was a characteristic finding for tuberculoma The combination with CT imaging was useful for the differentiation from malignant lesions.