对比基于PET/CT的不同方法定性诊断孤立性肺结节的效能  

Comparative analysis of different diagnostic methods based on PET/CT in qualitative diagnosis ofsolitary pulmonary nodules

作　　者：马宁 赵铭[2] 田蓉蓉[2] 刘洋[2] 李娟 杜红彦 MA Ning;ZHAO Ming;TIAN Rongrong;LIU Yang;LI Juan;DU Hongyan(Department of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China;PET/CT Center,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China;Department of Medical Imaging,Tumor District of Xinzheng Traditional Chinese Medicine Hospital,Xinzheng 451150,China)

机构地区：[1]山西医科大学医学影像学系,山西太原030001 [2]山西省肿瘤医院PET/CT中心,山西太原030013 [3]新郑市中医院肿瘤院区医学影像科,河南新郑451150

出　　处：《中国介入影像与治疗学》2020年第4期233-237,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的对比观察基于PET/CT的不同方法定性诊断孤立性肺结节(SPN)的效能。方法收集161接受PET/CT检查的SPN患者,比较良恶性SPN患者间临床表现、高分辨率CT(HRCT)征象及SUV max值的差异;通过二元Logistic回归构建SPN的数学诊断模型,比较诊断模型、PET/CT及HRCT的诊断效能。结果161例SPN中,经病理诊断恶性131例,良性30例。PET/CT诊断恶性SPN的灵敏度、特异度及准确率分别为98.47%(129/131)、76.67%(23/30)及94.41%(152/161),HRCT分别为59.54%(78/131)、83.33%(25/30)及63.98%(103/161)。经单因素及多因素分析后,将SUV max、年龄、钙化及气管血管集束纳入回归方程并建立模型,模型诊断恶性SPN的敏感度、特异度及准确率分别为82.44%(108/131)、86.67%(26/30)及83.23%(134/161)。ROC曲线结果显示,模型、PET/CT及HRCT诊断恶性SPN的AUC分别为0.909、0.876及0.714,PET/CT及模型的AUC均高于HRCT(P均<0.001),模型与PET/CT差异无统计学意义(P=0.468)。结论基于PET/CT的Logistic回归模型及PET/CT定性诊断SPN的效能优于HRCT,且特异度高于PET/CT。Objective To compare the qualitative diagnostic value of different methods based on PET/CT for solitary pulmonary nodules(SPN).Methods Data of 161 SPN patients who underwent PET/CT were collected.Clinical information,high resolution CT(HRCT)signs and maximum standard uptake value(SUV max)were compared between benign and malignant SPN patients.The mathematical diagnostic model of SPN was constructed by using binary Logistic regression,and the diagnostic efficiencies were compared among diagnostic model,PET/CT and HRCT.Results Among 161 patients,malignant SPN were pathologically diagnosed in 131 cases and benign in 30 cases.The sensitivity,specificity and accuracy of PET/CT in diagnosing malignant SPN was 98.47%(129/131),76.67%(23/30)and 94.41%(152/161),of HRCT was 59.54%(78/131),83.33%(25/30)and 63.98%(103/161),respectively.After univariate and multivariate analysis,SUV max,patient's age,calcification and tracheal vascular bundles were incorporated into the regression equation,and a model was then established.The sensitivity,specificity and accuracy of the model for diagnosing malignant SPN was 82.44%(108/131),86.67%(26/30)and 83.23%(134/161),respectively.The AUC of the model,PET/CT and HRCT for diagnosis of malignant SPN was 0.909,0.876 and 0.714,respectively.The AUC of the model and PET/CT were both higher than HRCT(all P<0.001).There was no significant difference between the model and PET/CT(P=0.468).Conclusion PET/CT-based Logistic regression model and PET/CT are better than HRCT in qualitative diagnosis of SPN,and the specificity of the model is higher than that of PET/CT.

关 键 词：孤立性肺结节 正电子发射断层显像术 氟脱氧葡萄糖F18 诊断模型 

分 类 号：R734.2[医药卫生—肿瘤] R817.4[医药卫生—临床医学]