^(18)F-FDG符合线路SPECT/CT显像半定量分析对肺部病变的诊断价值  

The diagnostic value of semi-quantitative analysis of pulmonary lesions by using ^(18)F-FDG coincidence SPECT/CT imaging

作　　者：陆武[1,2] 陈鹏[1,2] 刘永[1,2] 宋长祥[1,2] 杜鹏[1,2] 

机构地区：[1]徐州医学院附属连云港医院 [2]连云港第一人民医院核医学科,江苏222002

出　　处：《放射学实践》2014年第9期1046-1049,共4页Radiologic Practice

基　　金：连云港市卫生局资助课题(1304)

摘　　要：目的:探讨18F-FDG符合线路SPECT/CT显像对肺部病变的诊断价值。方法:回顾性分析经病理或随访证实的144例肺部病变患者的18F-FDG符合线路SPECT/CT检查图像,采用半定量法测量肺部病灶放射性计数(T)与胸壁软组织放射性计数(NT),并计算其放射性摄取比值R(T/NT),应用受试者工作特征(ROC)曲线确定肺部良恶性病变的最佳临界值R(cutoff),即R≥R(cutoff)诊断为恶性病变,R<R(cutoff)诊断为良性病变。结果:R(cutoff)取3.58,即病灶R≥3.58作为恶性的判定标准,诊断敏感度、特异度、准确率、阳性预测值和阴性预测值分别为89.5%、89.7%、89.6%、95.9%和76.1%,且与病理诊断的一致性良好(Kappa=0.750,P<0.05)。结论:18F-FDG符合线路SPECT/CT显像对肺部病变的诊断、鉴别诊断及预后评估具有重要的临床应用价值。To explore the diagnostic value of 18 F-FDG coincidence SPECT/CT imaging in diagnostic of lung lesions.Methods：Images of 144 patients with lung diseases confirmed by pathology or follow-ups were analyzed retro-spectively.The maximum radioactivity count of the lung lesions （T）and normal chest wall soft tissues （NT）were meas-ured by the two experienced nuclear medicine doctors and the ratios of R （T/NT）were calculated.The optimal threshold of R （cutoff）was identified by the receiver operating characteristic （ROC）curve analysis.With optimal threshold,R≥R （cut-off）was diagnosed as malignant lesions,R〈R （cutoff）was diagnosed as benign lesions,and the data were analyzed statisti-cally.Results：The optimal threshold value （R-cutoff）was 3.58.When R （cutoff）≥3.58 the tumors were diagnosed as ma-lignant lesions.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were respective-ly：89.5%,89.7%,89.6%,95.9% and 76.1%,showing adequate consistency as compared with pathologic diagnosis （Kap-pa=0.750,P〈0.05）.Conclusion：18 F-FDG-Coincidence SPECT/CT imaging is clinically valuable for diagnosis,differential diagnosis and prognosis in lung diseases.

关 键 词：单光子发射计算机体层摄影术 肺疾病 氟脱氧葡萄糖F18 诊断 鉴别 

分 类 号：R563[医药卫生—呼吸系统] R445.6[医药卫生—内科学]