^(18)FDG-符合探测显像与CT融合对肺癌淋巴结转移的诊断  

Value of ^(18)FDG coincidence circuit CT in diagonsis of lymphnode metastasis in non-small cell lung sancer

作　　者：金钟男[1] 徐进志[1] 李野[1] 申宝忠[1] 

机构地区：[1]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150001

出　　处：《中国热带医学》2009年第8期1480-1482,共3页China Tropical Medicine

摘　　要：目的探讨使用18氟-脱氧葡萄糖(18FDG)和符合线路计算机断层显像仪(SPECT/PET)的18FDG-PET显像与多层螺旋CT(MSCT)异机图像融合对非小细胞肺癌(NSCLC)淋巴结转移的诊断价值。方法66例确诊为NSCLC患者术前行18FDG-PET显像及胸部64层螺旋CT检查,18FDG-PET图像与64层螺旋CT进行异机图像融合,获得横断面、矢状面、冠状面三维断层图像。利用感兴趣区技术(ROI)的半定量分析计算病变淋巴结(L)与周围纵隔组织(N)的摄取比值R(L/N)。将18FDG-PET检查对肺癌淋巴结转移分期的诊断结果均与术后病理结果进行比较。结果以摄取比值R≥1.5为判断标准,诊断肺癌淋巴结转移的灵敏度为90%(27/30例)、特异度为80.6%(29/36例)、准确率为84.8%(56/66例)、阳性和阴性预测值分别为79.4%(27/34例)和90.6%(29/32例)。27例18FDG-PET显像为阳性的转移淋巴结的分析最大摄取比值为11.5最小为1.7。结论SPECT/PET的18FDG-PET显像对肺癌的纵隔淋巴结转移分期诊断具有较高的灵敏度、特异度和阴性预测值,可为临床确定治疗方案和观察疗效提供重要的临床依据。Objective To evaluate the diagnostic significance of ^18FDG coincidence circuit SPECT/MSCT in preoperative mediastinal lymph node staging for NSCLC. Methods Whole body ^18FDG coincidence circuit SPECT and enhanced thoracic 64 slice thoracic CT examination were used on in 66 NSCLC patients by separate equipment one week before thoraeotomy of pulmonary lobectomy or pneumonectomy and lymph nodes dissection. Image fusion of SPECT and 64 slice thoracic CT was performed in esoft platform., and three dianaensions image of cross section, sagittal plane and coronal plane were obtained.The histological examination of lymph nodes sampled from thoracotomy was used as the standard for mediastinal lymph node metastasis staging. Results R ≥ 1.5 was taken as the positive standard. The sensitivity,specificity, accuracy,positive predictive value and negative predictive value of SPECT/PET were 90% （27/30）,80.6% （29/36）, 84.8% （56/66）,79.4%（27/34） and 90.6% （29/32）, respectively. Conclusion ^18FDG SPECT/PET image is highly sensitive, specific and with a high negative predictive value than enhanced 64 slice CT for accurate mediastinal lymph nodes metastasis staging and may provide more evidence for determination of therapeutic schedule and observation of therapeutic effect on NSCLC patients.

关 键 词：^18FDG 符合线路 64层CT 图像融合 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]