^(18)F-FDG PET/CT双时相显像对孤立性肺结节的诊断价值  

The clinical value of dual time point ^(18)F-FDG PET/CT in diagnosis of solitary pulmonary nodule

作　　者：姚稚明[1] 屈婉莹[1] 刘甫庚[2] 韩丽君[1] 于治国[1] 李伟[1] 赵波沣[1] 朱明[1] 张建飞[1] 

机构地区：[1]卫生部北京医院核医学科,100730 [2]卫生部北京医院放射科,100730

出　　处：《中华核医学杂志》2007年第1期5-7,共3页Chinese Journal of Nuclear Medicine

摘　　要：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 The aim of this study is to evaluate the clinical value of dual time point ^18F- fluorodeoxyglucose （FDG） PET/CT in differential diagnosis of solitary pulmonary nodule （SPN）. Methods Thirty one patients with SPN underwent dual time point FDG PET/CT imaging and 5 - 17 months follow-up. The standardized uptake value （SUV） of SPN of early and delay phase was measured at 60 and 120 min respectively. Results In patients with lung cancer, the SUV of nodule increased significantly at delay phase from that at early one; however, there was no significant difference between early and delay SUVmaxS. If △SUV t〉 15% was taken as the cutoff point, the sensitivity and specificity in detection of lung cancer were 81.8% and 77.8%, respectively. The positive predictive value and negative predictive value were 93.3% and 85.7%, respectively. If other morphological criteria was added, the sensitivity and specificity of PET/CT improved further to 95.4% and 85.7%, respectively. Condusions The dual time point ^18FFDG PET/CT is useful in diagnosis of SPN. Moreover, careful interpretation of both CT and PET data is necessary to improve the diagnostic accuracy.

关 键 词：肺肿瘤 诊断 鉴别 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R817.4[医药卫生—影像医学与核医学]