使用CT在患有异位ACTH综合征的患者中区分肺部神经内分泌瘤与瘤状感染
Lan Song1, Hui Miao2, Zhenchen Zhu1,3
1Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Insights into imaging
|August 1, 2024
概括
肺神经内分泌瘤 (NENs) 和肺部感染可以在异位上腺皮质激素综合征 (EAS) 中互相模仿. CT成像功能有助于区分这些疾病,使EAS患者能够准确诊断和治疗.
科学领域:
- 肺部医学 肺部医学
- 放射学 放射学是指放射学
- 内分泌学 在内分泌学.
背景情况:
- 肺神经内分泌瘤 (NENs) 是异位上腺皮质激素综合征 (EAS) 的主要原因.
- 肺部感染可能会在EAS患者中呈现类似于NEN的成像发现,从而使诊断复杂化.
- 准确的区分对于适当的患者管理至关重要.
研究的目的:
- 调查与宫外 adrenocorticotropic 激素综合征 (EAS) 相关的肺成像指标.
- 在EAS患者中使用成像来区分肺神经内分泌新生瘤 (NENs) 和类似瘤的感染.
- 为了在罕见的EAS病例中识别差异诊断的CT关键特征.
主要方法:
- 追溯研究包括59名EAS患者 (45名NEN,14名感染).
- 对临床表现,CT特征和PET/CT (F-FDG或Ga-DOTATATE) 发现的分析.
- 病理学结果被用于确定的诊断.
主要成果:
- 与NENs组相比,感染组显示出更高的C反应蛋白和吐量,较低的氧和度.
- 肺部NEN通常是孤独的外周瘤.
- 感染呈现为多焦点的外周病变,具有诸如腔,尖膜和膜收缩等特征.
- 德尔塔CT值 (动脉相增量) 显示了NEN的中等预测能力 (48.3 HU,95.0%的灵敏度,54.1%的特异性).
结论:
- 胸部CT扫描对于定位和表征EAS中的肺病变非常有价值.
- 截然不同的CT标志区分了NEN (单独的,血管/气道感染) 和感染 (多焦点,外围,腔,).
- 薄切片CT有助于迅速差分诊断和肺部EAS病变的有效治疗.
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