双时相PET/CT显像对低代谢孤立性肺结节的诊断价值  

The role of dual time point PET/CT imaging in diagnosis of solitary pulmonary nodule with low metabolism

作　　者：林洁[1] 唐坤[1] 殷薇薇[1] 郑祥武[1] 陈杨宗[1] 林信实 戴云飞[1] 包纯纯[1] 张秀形 王志强[1] 赵亮[1] 

机构地区：[1]温州医科大学附属第一医院放射影像中心PET/CT室,浙江温州325015

出　　处：《温州医学院学报》2014年第9期688-691,共4页Journal of Wenzhou Medical College

摘　　要：目的:探讨双时相18F-脱氧葡萄糖(FDG)PET/CT显像对早期SUVmax≤2.5的低代谢孤立性肺结节(SPN)的诊断价值。方法:回顾性分析2011年9月-2013年6月在我院诊断为SPN且PET/CT早期显像SUVmax值≤2.5的45例患者的临床资料。45例患者中男27例,女18例,平均年龄为(59.71±11.42)岁。所有患者注射显像剂后60 min行PET/CT早期显像,120 min后行延迟显像。以半定量方法测定结节早期及延迟期SUVmax值,并计算延迟显像与早期显像SUVmax的差值(△SUVmax)。以△SUVmax≥0为阳性判断标准对结节进行定性诊断,计算其诊断的灵敏度、特异性、准确性,并绘制受试者工作特征(ROC)曲线以分析其诊断低代谢SPN的效能。结果:良恶性结节间的早期、延迟期SUVmax平均值差异均无统计学意义(t=0.193,P=0.848;t=1.452,P=0.154);恶性结节的平均△SUVmax值较良性结节显著增加,差异有统计学意义(t=2.738,P=0.009)。以△SUVmax≥0为阳性判断标准诊断低代谢SPN的灵敏度、特异性、准确性、阳性预测值及阴性预测值分别为87.88%、66.67%、82.22%、87.88%及66.67%。△SUVmax诊断低代谢SPN的ROC曲线下面积为0.861。结论:双时相PET/CT显像延迟期与早期显像的SUVmax差值(△SUVmax)诊断低代谢SPN的灵敏度及阳性预测值较高,对于早期SUVmax≤2.5且无典型形态学特征的SPN,建议常规行双时相PET/CT检查以鉴别。Objective：To evaluate the role of dual time point 18F-FDG PET/CT imaging in diagnosis of solitary pulmonary nodule （SPN） with low metabolism. MethodDuring August 2011 to June 2013, forty-ifve patients conifrmed with SPN and SUVmax≤2.5 at early PET/CT imaging were retrospectively analysed （male 27, female 18, mean age 59.71±11.42 years）. All patients were performed with early and delayed PET/CT imag-ing at 60 min and 120 min after intravenous injection respectively. The eraly and delayed maximum standardized uptake value （SUVmax） of PET/CT imaging were measured and the change of SUVmax （△SUVmax） was cal-culated. The sensitivity, speciifcity and accuracy were calculated using the△SUVmax≥0 as diagnostic positive standard, and the receiver operating characteristic （ROC） curve was used to evaluate the diagnostic vale of△SU-Vmax for low metabolic SPN. ResultThe differences in average SUVmax of early and delayed imaging be-tween benign and malignant nodules had no statisticly signiifcance （t=0.193, P=0.848, t=1.452, P=0.154）. There was signiifcant difference in mean△SUVmax between malignant and benign lesions （t=2.738, P=0.009）. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value were 87.88%, 66.67%, 82.22%, 87.88%and 66.67%respectively with△SUVmax≥0 as diagnostic positive standard. The area under ROC curve was 0.861 according to the△SUVmax. Conclusion：The dual time point PET/CT imaging is use-ful for differentiating solitary pulmonary nodules with early SUVmax≤2.5 and without speciifc morphological characteristics.

关 键 词：肺肿瘤 体层摄影术 发射型计算机 诊断 鉴别 脱氧葡萄糖 

分 类 号：R81[医药卫生—放射医学]