^(18)F-FDG PET/CT显像对胰腺良恶性病变的诊断价值  

Diagnosis of ^(18)F-FDG PET/CT Imaging in Benign and Malignant Pancreatic Lesions

作　　者：郑立春[1] 刘桂超[1] 欧阳向柳 张文军[1] 张晓明[1] ZHENG Lichun;LIU Guichao;OUYANG Xiangliu;ZHANG Wenjun;ZHANG Xiaoming(Department of Nuclear Medicine,Tangshan Gongren Hospital,Tangshan 063000,China)

机构地区：[1]唐山市工人医院核医学科,河北唐山063000 [2]唐山市工人医院超声诊断科,河北唐山063000

出　　处：《中国医学影像学杂志》2018年第9期680-684,共5页Chinese Journal of Medical Imaging

基　　金：河北省医学科学研究重点课题(20150955)

摘　　要：目的探讨18F-FDGPET/CT显像对胰腺良恶性病变的鉴别诊断价值。资料与方法回顾性分析2012年1月—2017年6月唐山市工人医院收治的69例胰腺病变患者^(18)F-FDG PET/CT资料。以病理或随访结果为标准,分析良恶性病灶最大标准化摄取值(SUVmax)、双时相显像滞留率(RI)、胰腺病灶/肝脏SUVmax比值(T/L)的差异;以SUVmax、RI、T/L为指标绘制受试者工作特性(ROC)曲线,并计算其诊断敏感度、特异度、准确率、阳性预测值、阴性预测值,比较3种指标对胰腺良恶性病变的诊断效能。结果研究共纳入76枚病灶,其中恶性病灶49枚、良性病灶27枚,胰腺良、恶性病变SUVmax分别为2.33±1.18和4.44±2.27,差异有统计学意义(U=149.500,P<0.01),SUVmax诊断ROC曲线下面积为0.856,阈值为2.41,敏感度、特异度、准确率、阳性预测值、阴性预测值分别为91.11%、73.91%、85.29%、87.23%、80.95%。良、恶性病灶RI分别为7.36±13.17和24.95±12.32,差异有统计学意义(U=163.500,P<0.01),RI诊断ROC曲线下面积为0.842,阈值为18.55,敏感度、特异度、准确率、阳性预测值、阴性预测值分别为66.67%、91.30%、75.00%、93.75%、58.33%。良、恶性病灶T/L分别为0.89±0.45和1.80±1.12,差异有统计学意义(U=129.000,P<0.01),T/L诊断ROC曲线下面积为0.875,阈值为1.04,敏感度、特异度、准确率、阳性预测值、阴性预测值分别为88.89%、82.61%、87.76%、90.91%、79.17%。结论 ^(18)F-FDGPET/CT显像对胰腺良恶性病变具有较高的鉴别诊断价值。半定量指标T/L具有较好的诊断效能。Purpose To explore the diagnostic value of ^18F-FDG PET/CT imaging in differentiating benign pancreatic lesions and malignant ones. Materials and Methods Retrospective analysis of ^18F-FDG PET/CT data from 69 patients with pancreatic lesions in Tangshan Gongren Hospital from January 2012 to June 2017 was performed. The differences in maximum standardized uptake value （SUVmax）, retention index （RI） and T/L ratios between benign and malignant lesions were analyzed by the standard of pathology and follow-up. ROC curves were plotted with SUVmax, RI and T/L as indicators, the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated. The diagnostic efficacy of 3 indicators on benign and malignant pancreatic lesions was compared. Results A total of 76 lesions were included in the study, including 49 malignant lesions and 27 benign lesions. The mean SUVmax values of benign pancreatic lesions and malignant ones were 2.33±1.18 and 4.44±2.27, respectively; the difference of which was statistically significant （U=149.500, P〈0.01）. When ROC curve had an area under curve （AUC） of 0.856 and threshold value of 2.41, its sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 91.11%, 73.91%, 85.29%, 87.23% and 80.95%, respectively; and the mean RI value of benign and malignant lesions were 7.36±13.17 and 24.95±12.32, the difference of which was statistically significant （U=163.500, P〈0.01）. When ROC curve had an AUC of 0.842 and threshold value of 18.55, its sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 66.67%, 91.30%, 75.00%, 93.75% and 58.33%, respectively; and the mean T/L value of benign and malignant lesions were 0.89±0.45 and 1.80±1.12, the difference of which was statistically significant （U=129.000, P〈0.01）. When ROC curve had an AUC of 0.875 and threshold value of 1.04, its sensitivity, specificity, accuracy, positive predictive value

关 键 词：胰腺疾病 胰腺肿瘤 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 诊断 鉴别 

分 类 号：R445.3[医药卫生—影像医学与核医学] R576[医药卫生—诊断学]