¾Ç¼º Á¾¾ç ȯÀÚ¿¡¼ Żũ È丷 À¯Âø¼ú ½ÃÇà ÈÄ ³ªÅ¸³ È丷 º¯È: Àç¹ßµÈ ¾Ç¼º È丷 º´º¯ÀÇ CT¿Í Fluorodeoxyglucose-Positron Emission Tomography/CT ¼Ò°ß°ú ºñ±³
Pleural Changes after Talc Pleurodesis in Patients with Underlying Malignancy: Comparison with Recurrent Malignant Pleural Lesions on CT and Fluorodeoxyglucose-Positron Emission Tomography/CT
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±è¹ü¼ö(Kim Beom-Su) - °í½Å´ëÇб³ º¹À½º´¿ø ¿µ»óÀÇÇаú
°Èñ(Kang Hee) - °í½Å´ëÇб³ º¹À½º´¿ø ¿µ»óÀÇÇаú
¹ÚÁ¤±¸(Park Jung-Gu) - °í½Å´ëÇб³ º¹À½º´¿ø ¿µ»óÀÇÇаú
Abstract
¸ñÀû: ¾Ç¼º Á¾¾çÀÇ ±â¿Õ·ÂÀÌ Àִ ȯÀÚ¿¡¼ Żũ È丷 À¯Âø¼ú ÀÌÈÄ¿¡ ¹ß»ýÇÑ ¾ç¼º È丷 º¯È¿Í Àç¹ß¼º ¾Ç¼º È丷 ÁúȯÀÇ CT¿Í fluorodeoxyglucose-positron emission tomography (ÀÌÇÏ FDG-PET)/CT ¼Ò°ßÀ» ºñ±³ÇØ º¸°íÀÚ ÇÑ´Ù.
´ë»ó°ú ¹æ¹ý: Żũ È丷 À¯Âø¼úÀ» ½ÃÇàÇÑ 194¸íÀÇ È¯ÀÚ Áß, ½Ã¼ú ÈÄ ÃßÀû CT¿Í FDG-PET/CT ÃÔ¿µÀ» ½ÃÇàÇÑ 16¸íÀÇ È¯ÀÚ¸¦ ´ë»óÀ¸·Î ÇÏ¿´´Ù. È丷 º´º¯ÀÇ CT¿Í FDG-PET/CT ¼Ò°ßÀ» Æò°¡ÇÏ°í ¾ç¼º È丷 º¯È¿Í Àç¹ß¼º ¾Ç¼º È丷 º´º¯ÀÇ ¼Ò°ßÀ» ºñ±³ÇÏ¿´´Ù.
°á°ú: ¾Ç¼º Á¾¾çÀÇ ±â¿Õ·ÂÀÌ ÀÖ´Â 16¸íÀÇ È¯ÀÚ¿¡¼ 22°³ÀÇ È丷 º´º¯ÀÌ Å»Å© È丷 À¯Âø¼ú ÀÌÈÄ¿¡ ¹ß»ýÇÏ¿´´Ù. ÃßÀû°üÂû¿¡¼ ¾ç¼º È丷 º¯È°¡ 6¸í(Áý´Ü 1)À̾úÀ¸¸ç Àç¹ß¼º ¾Ç¼º È丷 º´º¯ÀÌ 10¸í(Áý´Ü 2)À̾ú´Ù. Ư¡ÀûÀÎ °íÀ½¿µÀ»[mean, 131 Hounsfield unit (ÀÌÇÏ HU); range, 28~251 HU] µ¿¹ÝÇÑ È丷 ºñÈÄ°¡(mean, 13.4 mm; range, 4.9~62.3 mm) 15¸íÀÇ È¯ÀÚ¿¡¼ ³ªÅ¸³µ´Ù. CT¿¡¼ º¸ÀÎ ¸ð¾ç, µÎ²²¿Í FDG-PET/CT¿¡¼ ÃøÁ¤µÈ maximum standard uptake values´Â µÎ Áý´Ü °£¿¡ À¯ÀÇÇÑ Â÷ÀÌ°¡ ¾ø¾ú´Ù. CT¿¡¼ Á¶¿µÁõ° Àü °¨¼è°ªÀº Áý´Ü 1¿¡¼ ´õ ³ô°Ô ³ªÅ¸³µÀ¸¸ç(165 HU vs. 101 HU, p = 0.030), Á¶¿µÁõ°ÀÇ Á¤µµ´Â Áý´Ü 2¿¡¼ ´õ ³ô°Ô ÃøÁ¤µÇ¾ú´Ù(29 HU vs. 48 HU, p = 0.048). Áý´Ü 2¿¡¼¸¸ È丷 »ïÃâ(n = 5)°ú °íÀ½¿µÀÇ Ä§ÂøÀÌ µ¿¹ÝµÇÁö ¾ÊÀº È丷ºñÈÄ(n = 4)°¡ °üÂûµÇ¾úÁö¸¸ µÎ Áý´Ü °£¿¡ Åë°èÀû À¯ÀǼºÀº ¾ø¾ú´Ù.
°á·Ð: Żũ È丷 À¯Âø¼ú ÀÌÈÄ¿¡ ¹ß»ýÇÑ ¾ç¼º È丷 º¯È¿Í ºñ±³ÇßÀ» ¶§, ¾Ç¼º È丷 º´º¯Àº Á¶¿µÁõ° Àü CT¿¡¼ ´õ ³·Àº °¨¼è°ªÀ» º¸ÀÌ´Â µ¥ ºñÇØ Á¶¿µÁõ° ÈÄ CT¿¡¼ ´õ ³ôÀº Á¶¿µÁõ° ¼Ò°ßÀ» º¸ÀδÙ.
Purpose: To compare computed tomography (CT) and fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) findings of benign pleural changes with those of recurrent malignant pleural lesions in patients with a history of underlying malignancy after talc pleurodesis.
Materials and Methods: Of 194 patients who underwent talc pleurodesis, we retrospectively reviewed 16 patients for whom both follow-up CT and FDG-PET/CT were performed. The morphologic CT findings and maximum standard uptake values (SUVmax) were evaluated and compared between benign pleural changes and recurrent malignant pleural lesions.
Results: Twenty-two lesions were found in 16 patients; six patients had no evidence of active pleural disease (group 1) and 10 patients had recurrent malignant pleural lesions on radiological or clinical follow-up (group 2). Characteristic high-density pleural deposits [mean, 131 Hounsfield unit (HU); range, 28-251 HU] were seen along the pleural thickenings (mean, 13.4 mm; range, 4.9-62.3 mm) in 15 patients. The shape and thickness on CT and the SUVmax on FDG-PET/CT showed no significant differences between the two groups. On CT, the pre-contrast attenuation was higher in group 1 than group 2 (165 HU vs. 101 HU, respectively, p = 0.030), and the degree of enhancement was higher in group 2 than that in group 1 (29 HU vs. 48 HU, respectively, p = 0.048). Pleural effusions (n = 5) and other pleural thickening without high-density foci (n = 4) were observed only in group 2; however, no statistical significance was observed between the two groups.
Conclusion: Malignant pleural lesions can be characterized by lower pre-contrast attenuation and higher contrast enhancement, whereas benign pleural changes after talc pleurodesis are characterized by higher pre-contrast attenuation and lower contrast enhancement on CT.
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Talc Pleurodesis, Pleural Change, Talc Granuloma, CT, Positron Emission Tomography/CT
KMID :
1103720140700010035
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