Fluorodeoxyglucose positron emission tomography and CT after talc pleurodesis.
Fluorodeoxyglucose positron emission tomography and CT after talc pleurodesis.
复制标题
滑石粉胸膜固定术后氟脱氧葡萄糖正电子发射断层扫描和 CT。
作者：
B. Kwek;S. Aquino;A. Fischman
背景
滑石粉胸膜固定术广泛用于治疗持续性气胸或胸腔积液，特别是恶性积液。然而，有很少的数据表征氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）和CT结果治疗后。
方法
我们回顾性评价了9例接受滑石粉胸膜固定术治疗恶性胸腔积液或持续性漏气的患者的FDG-PET和CT研究。
结果
在滑石粉胸膜固定术后平均22个月进行FDG-PET研究，平均CT随访期为25个月。PET显示胸膜FDG摄取中度至重度斑块样或局灶性结节增加，平均标准化摄取值为5.4（SEM，1.2;范围，2.0至16.3）。FDG摄取呈弥漫性（2例患者）或局灶性（7例患者），最常发生在后肋间角（5例患者），其次是心尖区（3例患者）、前肋间角（1例患者）和前胸壁（1例患者）。CT上，胸膜增厚或结节化的高密度区域（平均值，230 Hounsfield单位[HU]; SEM，23 HU;范围，140至380 HU）对应于FDG摄取增加的区域。这些胸膜病灶的平均厚度为1.2 cm，长度可达8.2 cm（平均7.1 cm）。圆形胸膜结节最大3.1 cm（平均1.5 cm）。
结论
滑石粉胸膜固定术在PET上产生增加的FDG摄取，在CT上产生胸膜增厚的高密度区域，在连续成像上保持不变。当PET检测到胸膜腔中的摄取增加时，建议与CT相关联，以检测是否存在胸膜增厚或衰减增加，这表明滑石粉沉积而不是肿瘤。
BACKGROUND
Talc pleurodesis is widely performed for the management of persistent pneumothorax or pleural effusion, particularly malignant effusions. However, there are very few data characterizing fluorodeoxyglucose (FDG)-positron emission tomography (PET) and CT findings after treatment.
METHODS
We retrospectively evaluated the FDG-PET and CT studies of nine patients who underwent talc pleurodesis for the treatment of malignant pleural effusions or persistent air leak.
RESULTS
FDG-PET studies were performed on average 22 months after talc pleurodesis, and the mean CT follow-up period was 25 months. There was moderate-to-intense plaque-like or focal nodular-increased FDG uptake in the pleura on PET with mean standardized uptake value of 5.4 (SEM, 1.2; range, 2.0 to 16.3). The FDG uptake was either diffuse (two patients) or focal (seven patients), and most commonly occurred in the posterior costophrenic angles (five patients), followed by the apical regions (three patients), anterior costophrenic angle (one patient), and the anterior chest wall (one patient). On CT, high-density areas of pleural thickening or nodularity (mean, 230 Hounsfield units [HU]; SEM, 23 HU; range, 140 to 380 HU) corresponded to regions of increased FDG uptake. These pleural foci had an average thickness of 1.2 cm and measured up to 8.2 cm (mean, 7.1 cm) in length. Rounded pleural nodules were as large as 3.1 cm (mean, 1.5 cm).
CONCLUSIONS
Talc pleurodesis produces increased FDG uptake on PET and high-density areas of pleural thickening on CT that remain unchanged on serial imaging. When PET detects increased uptake in the pleural space, correlation with CT is recommended to detect the presence of pleural thickening of increased attenuation that suggests talc deposits rather than tumor.