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目的探讨肺炎型细支气管肺泡癌(PTBAC)多层螺旋CT(MSCT)和正电子发射体层成像(PET)影像学特征及其诊断价值。资料与方法回顾分析18例经病理证实的PTBAC的CT特点,其中9例行PET检查,对CT诊断正确率及其与PET结合后诊断正确率进行分析。结果18例肺实变密度均低于同层肌肉密度。支气管充气征或蜂房征9例,实变内血管造影征2例,混合阴影6例,边缘磨玻璃征1例。9例肺泡癌氟代脱氧葡萄糖(FDG)的摄取特点:单纯肺实变中斑片状高摄取3例,结节状高摄取4例,肺实变中有片状高摄取并纵隔淋巴结高浓聚1例,肺实变、肺部分结节及纵隔淋巴结均有高摄取1例。CT误诊2例,9例患者PET诊断中与CT相结合无一例误诊。结论PTBAC CT表现及对FDG的摄取特点多样,二者结合可以大大提高诊断率,减少误诊。
Objective To investigate the features and diagnostic value of multislice spiral CT (MSCT) and positron emission tomography (PET) imaging in patients with pneumonia type bronchioloalveolar carcinoma (PTBAC). Materials and Methods Retrospective analysis of 18 cases of pathologically confirmed CT features of PTBAC, including 9 cases of PET examination, the correct rate of CT diagnosis and its diagnosis after PET combined with correct rate. Results 18 cases of lung consolidation density were lower than the same layer of muscle density. Bronchial inflatable or bee sign in 9 cases, 2 cases of consolidation of angiography, mixed shadow in 6 cases, marginal ground glass sign in 1 case. The uptake characteristics of FDG in 9 cases of alveolar carcinoma were as follows: 3 cases of patchy hyperplasia in simple pulmonary solidification, 4 cases of high nodular hyperplasia, high sheet-like uptake of mediastinal lymph nodes and high concentration of mediastinal lymph nodes 1 in polygons, 1 in lungs, 1 in nodules of lung and mediastinal lymph nodes. CT misdiagnosis in 2 cases, 9 cases of PET diagnosis combined with CT without misdiagnosis. Conclusions The characteristics of PTBAC CT and the uptake of FDG are diverse. The combination of the two can greatly improve the diagnostic rate and reduce the misdiagnosis.