18F-脱氧葡萄糖正电子发射断层-X线计算机体层成像双时相显像在胃肠道良恶性病变鉴别诊断中的价值  

Value of dual-time-point lS F-fluorodeoxyglucose integrated positron emission and computed tomography in differentiation of malignant from benign gastrointestinal diseases

作　　者：许秀霞[1] 程娟[1] 徐文贵[1] 戴东[1] 宋秀宇[1] 马文超[1] 朱磊[1] 朱湘[1] 

机构地区：[1]天津医科大学附属肿瘤医院分子影像及核医学诊疗科天津市肿瘤防治重点实验室,300060

出　　处：《中华肿瘤杂志》2012年第5期364-368,共5页Chinese Journal of Oncology

基　　金：天津市自然科学基金重点项目（08JCZDJC23700）;天津市教委课题（20080133）

摘　　要：目的探讨18F-脱氧葡萄糖正电子发射断层-X线计算机体层成像（18F—FDGPET—CT）双时相显像对鉴别胃肠道良恶性病变的价值。方法65例临床怀疑胃肠道病变的患者行18F—FDGPET-CT双时相显像，以标准摄取值（SUV）作为半定量指标。两次显像的SUV最大值分别记为早期显像SUVmax和延迟显像SUVmax，计算SUVmax变化率（ASUVmax）。绘制早期显像SUVmax、延迟显像SUVmax、ASUVmax的ROC曲线，找到最佳诊断分界点，分别计算以早期显像SUVmax、延迟显像SUVmax和ASUVmax为标准的敏感度、特异度、阳性预测值、阴性预测值和准确率。结果胃肠道恶性病变延迟显像的SUVmax明显高于早期显像（P〈0．001），而良性病变早期和延迟显像的SUVmax差异无统计学意义（P=0．451）。恶性病变组的ASUVmax明显高于良性病变组。以早期显像的SUVmax〉19．2作为阳性诊断标准，其诊断的敏感度为72．7％，特异度为85．7％，阳性预测值为91．4％，阴性预测值为60．0％，准确率为76．9％。以延迟显像的SUVmax≥10．9作为阳性诊断标准，其诊断的敏感度为75．0％，特异度为90．5％，阳性预测值为94．3％，阴性预测值为63．3％，准确率为80．0％。以ASUVmaxt〉5．1％作为阳性诊断标准，其诊断的敏感度为95．5％，特异度为85．7％，阳性预测值为93．3％，阴性预测值为90．0％，准确率为92．3％。双时相显像诊断的准确率明显高于单次显像。结论”F．FDGPET—CT双时相显像对鉴别胃肠道良恶性病变有一定的价值，优于单次显像。Objective To explore the value of dual-time-point 18F-fluorodeoxyglucose integrated positron emission and computed tomography （18 F-FDG PET-CT） in differentiation of malignant from benign gastrointestinal diseases. Methods Sixty five patients with suspected gastrointestinal lesions underwent dual-time-point 18F-FDG PET-CT imaging. Standardized uptake value （SUV） was calculated for semi- quantitative assessment. The SUV of the two acquisitions were signed SUVearly and SUVdelayed, respectively. Then the change of SUVmax （ASUVmax） was calculated. The ROC curves of the SUVearly, SUVdelayed and ASUV were drawn to find the best cut-off point value for differential diagnosis, and then the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated, respectively. Results Of the malignant lesions, the SUVmax in delayed imaging were significantly higher than those in early imaging, while there were no significant differences of SUVmax between the two images of the benign lesions. The ASUVmax of the malignant lesions were significantly higher than that of the benign ones. Taking the SUVmax higher than 9.2 in early imaging as positive diagnostic criteria, the sensitivity was 72.7%, the specificity was 85.7%, the positive predictive value was 91.4%, the negative predictive value was 60.0%, and the accuracy was 76.9%. Taking the SUVmax higher than 10.9 in delayed imaging as positive diagnostic criteria, the sensitivity was 75.0%, the specificity was 90.5%, the positive predictive value was 94.3%, the negative predictive value was 63.3% , and the accuracy was 80.0%. Taking the ASUVmax higher than 5.1% as positive diagnostic criteria, the sensitivity was 95.5% , the specificity was 85.7% , the positive predictive value was 93.3%, the negative predictive value was 90.0%, and the accuracy was 92.3%. The accuracy of dual-time-point 18F-FDG PET-CT imaging was significantly higher than that of single-time point is F-FDG PET-CT imaging. Conclusion Dual-time-point is F-FDG PET

关 键 词：胃肠肿瘤 胃肠疾病 体层摄影术 发射型计算机 脱氧葡萄糖 诊断 鉴别 

分 类 号：R730.44[医药卫生—肿瘤]