18F-FDG PET/CT联合薄层螺旋CT三维重建对提高孤立性肺结节诊断的应用价值

目的：探讨18F-FDG PET/CT 联合薄层螺旋CT 三维重建对提高孤立性肺结节（SPN）诊断的应用价值。方法：选取2016年9月-2018年9月就诊于厦门大学附属中山医院核医学科有回访结果的139例SPN患者，患者应用18F-FDG PET/CT 常规扫描后进行肺部薄层螺旋CT扫描和三维重建，分析对比联合诊断和单独18F-FDG PET/CT 诊断的准确性。结果：SPN患者经术后或穿刺病理证实的有131例，其中恶性83例，良性55例，经临床抗炎治疗病灶变小或消失的有8例。联合诊断的SPN结节的灵敏度85.71%、特异度78.18%、诊断符合率82.73%均高于18F-FDG PET/CT诊断的64.29%、54.55%、60.43%（P＜0.05）。结论：18F-FDG PET/CT 联合CT 三维重建能明显提高对SPN 诊断的准确性，为SPN 的治疗决策提供依据，具有重要的临床意义。

The value of 18F-FDG PET/CT combined with three-dimensional reconstruction of thin-slice helical CT in improving diagnosis of solitary pulmonary nodules

Objective: To investigate the value of 18F-FDG PET/CT combined with three-dimensional reconstruction of thin-slice spiral CT in improving the diagnosis of solitary pulmonary nodules (SPN). Methods: 139 patients with SPN who were treated in the Department of Nuclear Medicine, Zhongshan Hospital Affiliated to Xiamen University from September 2016 to September 2018 were selected. After routine 18F-FDG PET/CT scanning, the patients underwent thin-slice spiral CT scanning and three-dimensional reconstruction. The accuracy of combined diagnosis and single 18F-FDG PET/CT diagnosis was analyzed and compared. Results: 131 patients with SPN were confirmed by pathology after operation or puncture, 83 of them were malignant, 55 were benign, and 8 were small or disappeared after clinical anti-inflammatory treatment. The sensitivity, specificity and coincidence rate of combined diagnosis of SPN nodules were 85.71%, 78.18% and 82.73% respectively, which were higher than 64.29%, 54.55% and 60.43% of 18F-FDG PET/CT diagnosis (P < 0.05). Conclusion: 18F-FDG PET/CT combined with CT three-dimensional reconstruction can significantly improve the accuracy of diagnosis of SPN, and provide basis for treatment decision-making of SPN, which has important clinical significance.