胸腔积液的^(18)F-FDG PET/CT病因诊断  

Etiological Diagnosis of Pleural Effusion Using ^(18)F-FDG PET/CT

作　　者：王长梅[1] 左传涛[2] 赵军[2] 谭海波[2] 华逢春[2] 张政伟[2] 薛方平[2] 管一晖[2] 

机构地区：[1]复旦大学附属金山医院核医学科,金山区金一路391号上海200540 [2]复旦大学附属华山医院PET中心,金山区金一路391号上海200540

出　　处：《中国医学计算机成像杂志》2009年第4期372-376,共5页Chinese Computed Medical Imaging

基　　金：上海市科委资助项目(编号:08511501300)~~

摘　　要：目的:不明原因胸腔积液病因的诊断是临床治疗的前提,本研究探讨18F-脱氧葡萄糖(FDG)PET/CT显像在病因诊断中的价值。方法:对43例原因未明的胸腔积液患者行18F-FDGPET/CT全身显像。结合PET和CT图像进行综合判断,PET结果的判断采用目测法和标准摄取值(SUV)测定。结果:恶性胸腔积液26例,良性17例(结核性7例,炎性6例,心源性4例)。26例恶性者中,21例PET/CT检出原发病灶,5例未找到原发病灶;6例炎性者PET/CT诊断明确;7例结核性中5例经PET/CT检查诊断明确,另2例误诊为恶性;心源性4例PET/CT检查阴性。18F-FDGPET/CT对不明原因胸腔积液病因诊断的灵敏度80.8%(21/26),特异性为88.2%(15/17),阳性预测值为91.3%(21/23),阴性预测值为75.0%(15/20)。结论:18F-FDGPET/CT可用于不明原因胸腔积液的病因诊断,并有较高的诊断准确率。Purpose： To evaluate the clinical value of ^18F- FDG PET/CT to detect the primary tumor in patients with unexplained pleural effusion. Methods： Forty - three patients with unexplained pleural effusion were undergone whole - body ^18F - FDG PET/CT. The images were interpreted by visual inspection and semi - quantitative analysis （ standardized uptake value , SUV） . And the results were analyzed by the combination of PET and CT. Results： According to the results of follow - up and pathology, twenty - six of 43 patients were confirmed malignant pleural effusion, and the others were caused by benign lesion（7 cases of tuberculosis, 6 cases of inflammation, 4 cases of cardiac disease） .The primary lesions were confirmed in twenty - one cases of the patients with unexplained pleural effusion by PET/CT, but still 5 patients were unknown. Six patients with inflammatory pleural effusion were confirmed by PET/ CT. Five of 7 patients with tuberculous pleural effusion were diagnosed accurately , while the other two were misdiagnosed for malignant disease. The result of PET/CT scan were negative in four patients with pleural effusion caused by cardiac disease. The sensitivity, specificity, positive predictive value, negative predictive value of ^18F - FDG PET/ CT in detecting the primary cause of unexplained pleural effusion were 80.8% （21/26）, 88.2% （ 15/17）, 91.3% （21/23） and 75.0% （15/20）. Conclusions ：^18F - FDG PET/CT can be used in etiological diagnosis of unexplained pleural effusion, and has a high diagnostic accuracy.

关 键 词：胸腔积液 ~18氟-脱氧葡萄糖 体层摄影术 发射型计算机 体层摄影术 X线计算机 

分 类 号：R817.4[医药卫生—影像医学与核医学] R816.4[医药卫生—放射医学]