18F-FDG PET/CT对青年患者良恶性肺内孤立性结节的鉴别诊断价值  

Analysis of 18F-FDG PET/CT Findings of Solitary Pulmonary Nodules in Young Patients

作　　者：闫港 王明华[1] YAN Gang;WANG Minghua(Department of Nuclear Medicine,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附院核医学科,贵州贵阳550004

出　　处：《贵州医科大学学报》2019年第11期1334-1338,共5页Journal of Guizhou Medical University

基　　金：贵州省科学技术基金[黔科合LH字(2016)7347]

摘　　要：目的:探讨氟代脱氧葡萄糖正电子发射型计算机体层成像(^18 F-FDG PET/CT)对17~44岁青年患者良恶性肺内孤立性结节(SPN)的鉴别诊断价值。方法:经病理证实或影像学检查随访2年以上确诊的79例青年SPN患者,其中肺癌44例、良性病变35例;采用^18 F-FDG PET/CT检测病灶形态、测量^18 F-FDG最大标准化摄取值(SUVmax),比较良恶性SPN患者SUVmax;绘制受试者工作特征曲线(ROC),分析SUVmax诊断恶性SPN的敏感性、特异性及最佳SUVmax界值,比较良恶性SPN的^18 F-FDG PET/CT特点,回归分析^18 F-FDG PET/CT征象及SUVmax对恶性SPN的预测价值。结果:恶性SPN患者SUVmax高于良性SPN患者(P<0.05),ROC曲线分析显示SUVmax诊断恶性SPN的最佳界值为2.9、敏感度为0.977、特异度为0.343;^18 F-FDG PET/CT图像中,恶性SPN分叶、毛刺、胸膜牵拉凹陷征及SUVmax≥2.9的出现率高于良性SPN(P<0.05),回归分析显示胸膜牵拉凹陷征及SUVmax≥2.9是恶性SPN的危险因素(P<0.05)。结论:^18 F-FDG PET/CT鉴别良恶性青年SPN敏感度高,胸膜牵拉凹陷征及SUVmax可用于预测恶性SPN。Objective:To investigate the diagnostic value of ^18 F-FDG position emission tomography/computed tomography(PET/CT)for young patients with differentiating solitary pulmonary nodule(SPNs).Methods:A retrospective analysis of 79 cases of SPN with PET/CT under 44 years of age confirmed by CT from July 2013 to November 20^18 was conducted.Each case with SPN was confirmed pathologically or received imaging examination follow-up for more than 2 years.Differential diagnosis of SPNs was made using morphological features in HRCT,visually detectable metabolism and semi-quantitative method.Results:Out of the 79 patients,44 were diagnosed as cases with lung cancer and 35 with benign lesions,50 males and 29 females,aged 17~44 years,with a median age of 34 years.The maximum standard uptake value(SUVmax)of the nodules was significantly higher in the malignant group than in the benign group(t=-7.287,P<0.05).The best SUV threshold for the diagnosis of the malignant nodules by ROC curve analysis was SUVmax≥2.9.The best index for the diagnosis of malignant nodules by regression analysis was pleural traction depression sign and SUVmax value≥2.9.Conclusion:^18 F-FDG PET/CT plays an important role in differentiating benign and malignant SPN in young patients.SUVmax value combined with HRCT sign can obviously improve the diagnostic efficacy of SPN,and PET/CT can provide effective diagnosis and treatment of SPN.

关 键 词：青年 孤立性肺结节 正电子发射型计算机体层成像 X线计算机 体层摄影术 诊断价值 

分 类 号：R445.6[医药卫生—影像医学与核医学]