基于18F-FDG PET/CT定性定量分析对于不明原因发热病因诊断价值研究  

Diagnostic Capacity of 18 F-FDG PET/CT in Patients with Fever of Unknown Origin based on Qualitative and Quantitative Analysis

作　　者：滕月 来瑞鹤 孙一文[1] 李爱梅[1] 蒋冲 Teng Yue;Lai Ruihe;Sun Yiwen(Department of Nuclear Medicine,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Jiangsu 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院核医学科,210008

出　　处：《医学研究杂志》2020年第6期170-174,共5页Journal of Medical Research

摘　　要：目的探讨18 F-FDG-PET/CT显像在不明原因发热(FUO)病因诊断中的临床价值。方法回顾分析笔者科室自2013年1月~2018年2月122例FUO患者18 F-FDG-PET/CT显像资料,以病理检查或临床随访结果为金标准,对18 F-FDG-PET/CT的诊断效能进行分析评价。结果122例FUO患者中,18 F-FDG PET/CT显像真阳性70例,假阳性12例,真阴性26例,假阴性14例,敏感度为83.3%,特异性为68.4%,阳性预测值为85.3%,阴性预测值为65.0%,准确性为78.7%。在半定量指标方面,恶性肿瘤的SUV max、SUV mean及SUV peak均显著高于感染(P<0.01,t=4.836;P<0.01,t=4.168;P<0.01,t=4.538)及非感染性炎症病灶(P<0.01,t=6.179;P<0.01,t=5.610;P<0.01,t=6.358),差异有统计学意义。感染病灶SUV max,SUV mean及SUV peak与非感染性炎症之间比较,差异无统计学意义(P=0.114,t=1.636;P=0.094,t=1.741;P=0.080,t=1.826)。结论18 F-FDG PET/CT定性及定量分析在FUO的病因诊断和鉴别诊断中具有重要价值。Objective To assess the diagnostic capacity of FDG PET/CT in the identification of the underlying cause of FUO.Methods One hundred and twenty-two consecutive patients who were diagnosed as FUO from January 2013 through February 2018 were retrospectively analyzed in this study.The performance of PET/CT for identifying the etiology of FUO was assessed.Before the FDG PET/CT studies,no definitive diagnosis was established for the patients investigated by conventional radiological,clinical and laboratory observations.Final diagnosis was based on histopathology,microbiologic assays,or clinical and imaging follow-up.Results Among the 122 patients with FUO,70 cases were true positive,12 cases were false positive,14 cases were false negative,26 cases were true negative,the sensitivity of PET/CT was 833%,the specificity was 68.4%,the positive predictive value was 85.3%,the negative predictive value was 65.0%,and the accuracy was 78.7%,respectively.In terms of glucose metabolism,SUV max,SUV mean and SUV peak in malignant tumors was significantly higher than that in infected lesions(P<0.01,t=4.836;P<0.01,t=4.168;P<0.01,t=4.538)and non-infected lesions(P<0.01,t=6.179;P<0.01,t=5.610;P<0.01,t=6.358).However,there was no significant difference between infected lesions and non-infected lesions with SUV max,SUV mean and SUV peak(P=0.114,t=1.636;P=0.094,t=1.741;P=0.080,t=1.826).Conclusion We conclude that 18 F-FDG PET/CT based on qualitative and quantitative analysis has an important role in the etiology diagnosis and differential diagnosis of FUO.

关 键 词：不明原因发热 正电子发射断层显像术 计算机体层扫描 诊断 

分 类 号：R445[医药卫生—影像医学与核医学]