18F-FDG PET-CT与增强CT对肺外结核诊断的对比研究  

Comparative study of 18F-FDG PET-CT and enhanced CT in the diagnosis of extrapulmonary tuberculosis

作　　者：余小忠[1] 姜忠宇[1] 周勤冰[1] 陈荐强 黄中柯[2] 

机构地区：[1]浙江衢化医院核医学科,浙江衢州324004 [2]浙江大学医学院附属邵逸夫医院核医学科,浙江杭州310003

出　　处：《中华医院感染学杂志》2017年第15期3480-3482,3486,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生基金资助项目(2015KYB220)

摘　　要：目的对比18氟-脱氧葡萄糖正电子发射计算机断层(18F-FDG PET-CT)显像与增强CT对肺外结核的诊断价值。方法选取2013年6月-2015年6月于医院就诊的46例疑似肺外结核患者临床病理资料,所有入组患者均行18F-FDG PET-CT并同机行增强CT,入组患者均取得病理或临床随访结果,比较不同检查方法在肺外结核诊断中的灵敏度、特异度、准确率、阳性预测值及阴性预测值;比较18F-FDG PET-CT和增强CT对误诊患者的鉴别诊断率。结果 18F-FDG PET-CT对肺外结核的诊断灵敏度、特异度、准确率、阳性预测值及阴性预测值均显著高于增强CT,差异均有统计学意义(P<0.05);增强CT对18F-FDG PET-CT误诊患者准确鉴别诊断率为42.9%,18F-FDG PET-CT对增强CT误诊患者准确鉴别诊断率为83.3%(P<0.05)。结论 18F-FDG PET-CT显像对各部位肺外结核的诊断价值较高,对增强CT误诊的患者鉴别诊断价值较高。OBJECTIVE To compare the diagnostic value of 18F-FDG PET-CT imaging and enhanced CT for extrapulmonary tuberculosis.METHODS Clinical data of 46 suspected extrapulmonary tuberculosis patients in our hospital from Jun.2013 to Jun.2015 were collected.All patients were screened by 18F-FDG PET-CT and enhanced CT using the same equipment,and were acquired pathology or clinical follow-up results.Sensitivity,specificity,accuracy,positive predictive value and negative predictive value of different screening methods for extrapulmonary tuberculosis diagnosis were compared.The differential diagnosis rate of 18F-FDG PET-CT and enhanced CT for misdiagnosed patients were compared.RESULTS Sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 18F-FDG PET-CT for extrapulmonary tuberculosis diagnosis were significantly higher than those of enhanced CT（P〈0.05）.The differential diagnosis rate of enhanced CT for patients misdiagnosed by 18F-FDG PET-CT was 42.9% ,and the differential diagnosis rate of 18F-FDG PET-CT for patients misdiagnosed by enhanced CT was 83.3% （P〈0.05）.CONCLUSION 18F-FDG PET-CT imaging has a higher diagnostic value for diagnosis of extrapulmonary tuberculosis in different parts of body,and a higher differential diagnosis value for patients misdiagnosed by enhanced CT.

关 键 词：正电子发射计算机断层显象 电子计算机断层扫描 肺外结核 诊断价值 

分 类 号：R521[医药卫生—内科学]