论文部分内容阅读
目的探讨~(18)F-脱氧葡萄糖(FDG)PET/CT 双时相显像对孤立性肺结节(SPN)的诊断价值。方法 31例 SPN 待查患者行~(18)F-FDG PET/CT 双时相显像,计算标准摄取值(SUV),随访时间5～17个月。结果 19例患者(61.3%)有病理学诊断结果,其余为临床诊断。肺癌患者结节的延迟相平均 SUV 明显高于早期相,早期相和延迟相最大 SUV 间无差异;单纯以平均 SUV 变化幅度[ASUV_(平均)=(SUV_(延迟)-SUV_(早期))/SUV_(早期)×100%]≥15%为诊断肺癌的标准,灵敏度为81.8%,特异性为77.8%,准确性为80.6%;PET/CT 综合的诊断灵敏度为95.5%,特异性为85.7%,准确性为87.1%。单纯以△SUV_(平均)≥15%为标准,诊断肺癌的阳性预测值和阴性预测值分别为90.0%和63.6%;以△SUV_(平均)≥15%伴结节放射性高于纵隔血池为标准,阳性预测值和阴性预测值分别为93.3%和85.7%。结论 ~(18)F-FDG PET/CT 双时相显像鉴别诊断 SPN 的良恶性有一定的临床价值,其与临床表现结合诊断准确性较高。
Objective To investigate the diagnostic value of ~ (18) F-FDG PET / CT dual-phase imaging in the diagnosis of solitary pulmonary nodules (SPN). Methods Totally 31 patients with SPN were examined with ~ (18) F-FDG PET / CT dual-phase imaging. The standard uptake (SUV) was calculated and the follow-up time ranged from 5 to 17 months. Results 19 patients (61.3%) had pathological diagnosis, the rest were clinical diagnosis. The mean SUV of delayed phase of lung cancer patients was significantly higher than that of the early phase, and the difference between the maximum SUV of early phase and delayed phase was not significant. The average SUV variation range [ASUV_ (average) = (SUV_ (delay) - SUV_ (early)) / SUV_ (early) × 100%] ≥15% was the standard for diagnosis of lung cancer with sensitivity of 81.8%, specificity of 77.8% and accuracy of 80.6%. The diagnostic sensitivity of PET / CT was 95.5% and the specificity was 85.7% , The accuracy is 87.1%. The positive predictive value and negative predictive value of diagnosing lung cancer were 90.0% and 63.6%, respectively, based on △ SUV_ (average) ≥15% alone. The radioactivity of △ SUV_ (average) ≥15% with nodules was higher than that of mediastinal blood pool The standard, positive predictive value and negative predictive value were 93.3% and 85.7% respectively. Conclusion The clinical value of ~ (18) F-FDG PET / CT dual-phase imaging in differential diagnosis of benign and malignant SPN has certain clinical value, which has high diagnostic accuracy in combination with clinical manifestations.