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F-18 FDG-Positron Emission Tomographic Scanning in Pulmonary Wegener's Granulomatosis

韋格納氏內芽腫的正子照影表現

摘要


以F-18 fluorodeoxyglucose顯影的正子照影(Positron emission tomography)已經成為惡性肺部病灶鑑別診斷的重要工具。但其專一性會受到發炎性病灶影響而降低。至目前為止,已經有許多的肺部結節性病變被提出可表現為正子照影陽性,如肺結核、組織漿菌症(histoplasmosis)、隱球菌症(Cryptococcosis)、類肉芽結節(sarcoidosis)和風濕性結節(rheumatoid nodule)。也有數種血管炎會表現正子照影陽性,如巨細胞血管炎(giant cell arteritis)、高安氏動脈炎(Takayasu's arteritis)、結節性多發動脈炎(polyarteritis nodosa)等。 韋格納氏內芽腫(Wegener's granulomatosis)是一結節性血管炎。我們提出兩個多發性肺部結節的個案,診斷皆為韋格納氏內芽腫;兩位的肺部病灶在正子照影下皆為陽性。本文並回顧相關個案報告,歸納韋格納氏內芽腫可能的正子照影特徵,包括:陽性顯影之多發性肺部結節並可能有開洞表現,合併鼻部或鼻竇部位陽性顯影之腫瘤,以及針對Wegener's granulomatosis治療後,追蹤的正子照影可見原陽性顯影的減退或消失。

並列摘要


Positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) has become an important tool in differentiating benign from malignant lung lesions. But, the specificity tends to be low, especially when chronic nonmalignant inflammatory processes are prevalent. Several kinds of vasculitis and granulomatous disease have been reported to have FDG-uptake in the scan. We presented 2 patients whose diagnosis of pulmonary Wegener's granulomatosis showed positive results with regard to the FDG-PET scan. From a literature review, we also tried to deduce the characteristics of PET scan results in Wegener's granulomatosis.

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