18F-FDG SPECT/CT与CT在肺结核合并肺癌患者诊断中的比较研究

摘要

目的:通过18F-FDG SPECT/CT与CT在肺结核合并肺癌患者诊断中的对比研究,评价18F-FDG SPECT/CT在诊断肺结核合并肺癌中的临床价值.方法:选取2013年3月-2016年3月我院收集确诊的100例肺结核合并肺癌患者,将肺癌病灶为周围型肺癌者分为I组,其中结核病灶为陈旧性结核者分为Ⅰa,活动性结核者分为Ⅰb;中心型肺癌者分为Ⅱ组,其中陈旧性结核者分为Ⅱa,活动性结核者分为Ⅱb,均行18F-FDG SPECT/CT扫描,并与CT对比研究.结果:100例患者中Ⅰa组47例,Ⅰb组24例,Ⅱa组17例,Ⅱb组12例.患者中肺结核病灶以双肺上叶尖后段及下叶背段分布为主(78.0%),与肺癌病灶分布有差异(P<0.001).Ⅰa组SPECT/CT、CT检出率分别为95.74%、80.85%,SPECT/CT检出率高于CT(P=0.001).Ⅰb组SPECT/CT、CT检出率分别为79.17%、75.00%,SPECT/CT检出率与CT检出率的差异无统计学意义(P=0.502).Ⅱa组SPECT/CT、CT检出率分别为94.12%、70.59%,SPECT/CT检出率高于CT(P<0.001).Ⅱb组SPECT/CT、CT检出率分别为75.00%、66.67%,SPECT/CT检出率与CT检出率的差异无统计学意义(P=0.213).结论:18F-FDG SPECT/CT在肺结核合并肺癌的诊断上,具有较高的临床价值,尤其对于非活动性肺结核合并肺癌的诊断上优于CT.%Objective:To explore the diagnostic value of 18F-FDG SPECT/CT,compared with that of CT alone in the diagnosis of patients with pulmonary tuberculosis complicated with lung cancer.Methods:A retrospective study was conducted in 100 patients with confirmed diagnosis of pulmonary tuberculosis complicated with lung cancer from March 2013 to March 2016.SPECT/CT images of all patients were analyzed and compared with CT scan.All patients were divided into four groups.Group Ⅰa were the patients with the peripheral lung cancer complicated with inactive tuberculosis.Group Ⅰb were the patients with the peripheral lung cancer complicated with active tuberculosis.GroupⅡa were the patients with the central lung cancer complicated with inactive tuberculosis.Group Ⅱb were the patients with the central lung cancer complicated with active tuberculosis.Results:Among one hundred patients,there was statistically significant difference in distribution oflesions between tuberculosis and lung cancer(P<0.001).In groupⅠa,the detection rates of SPECT/CT and CT were 95.74% and 80.85%,and the detection rate of SPECT/CT was higher than that of CT(P=0.001).In groupⅠb,the detection rates of SPECT/CT and CT were 79.17% and 75.00%,and there was no significant difference between the detection rate of SPECT/CT and that of CT(P=0.502).In groupⅡa,the detection rates of SPECT/CT and CT were 94.12% and 70.59%,and the detection rate of SPECT/CT was higher than that of CT(P<0.001).In groupⅡb,the detection rates of SPECT/CT and CT were 75.00% and 66.67%,and there was no significant difference between the detection rate of SPECT/CT and that of CT(P=0.213).Conclusion:SPECT/CT is superior to CT scan in the detection of patients with pulmonary tuberculosis complicated with lung cancer,especially for the diagnosis of inactive tuberculosis complicated with lung cancer.