^18F-FDG PET/CT在发热待查中的单中心大样本临床应用研究  

^18F-FDG PET/CT imaging in fever of unknown origin:data from a large single-center cohort

作　　者：李原[1] 王茜[1] 陈紫薇 陈津川 赵赟赟[1] 高平[1] 邱李恒 郝科技 李河北[1] 岳明纲[1] Li Yuan;Wang Qian;Chen Ziwei;Chen Jinchuan;Zhao Yunyun;Gao Ping;Qiu Liheng;Hao Keji;Li Hebei;Yue Minggang(Department of Nuclear Medicine,Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院核医学科,100044

出　　处：《中华核医学与分子影像杂志》2020年第8期452-458,共7页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的了解发热待查(FUO)的病因构成,并探讨^18F-脱氧葡萄糖(FDG)PET/CT对FUO中不同类型疾病的鉴别诊断作用。方法回顾性分析2013年1月至2019年8月间在北京大学人民医院行^18F-FDG PET/CT检查的466例FUO患者[男194例,女272例,年龄3~91(52.7±20.9)岁]的临床及影像资料。根据最终临床诊断分析FUO患者的病因学分布情况,观察不同类别疾病的PET/CT显像表现;以临床问卷方式评估^18F-FDG PET/CT对FUO的鉴别诊断意义。采用χ^2检验分析组间的构成比差异。结果本组FUO患者中的常见疾病类型依次为风湿免疫病(48.7%,227/466)、感染(28.5%,133/466)和恶性肿瘤(11.2%,52/466)。PET/CT检查中有95.5%(445/466)的患者表现为阳性,其中70.3%(313/445)发现局灶性病变,另29.7%(132/445)仅表现非特异性异常摄取。不同类型疾病中病变易累及部位、形态学改变及FDG摄取情况有所差异。问卷调查结果示,在FUO诊疗过程中PET/CT检查可使95.9%(447/466)的患者获益。与其他类型疾病相比,PET/CT对恶性肿瘤可更多地提示明确诊断(χ^2值:14.408~25.466,均P<0.001);对于风湿免疫病,PET/CT帮助或直接提示病因诊断的比例较感染组和不明原因组更高(χ^2值:7.922和9.647,均P<0.05)。结论^18F-FDG PET/CT显像对FUO病因诊断具有较高的临床价值,并可提供多层面诊断信息。Objective To further understand the etiological distribution of fever of unknown origin(FUO)in patients underwent^18F-fluorodeoxyglucose(FDG)PET/CT imaging,and to explore the significance of^18F-FDG PET/CT in the diagnosis of different types of diseases in FUO patients.Methods From January 2013 to August 2019,the clinical and PET/CT image data of 466 FUO patients(194 males,272 females,age:3-91(52.7±20.9)years)in Peking University People′s Hospital were retrospectively analyzed.The etiological distribution of FUO patients was analyzed according to the final clinical diagnosis.PET/CT imaging manifestations were analyzed for different types of diseases in FUO patients.The role of^18F-FDG PET/CT in differential diagnosis for FUO was evaluated through clinical questionnaire.Data were analyzed by usingχ^2 test.Results The common disease types in FUO patients were rheumatic and immune disease(48.7%,227/466),infection(28.5%,133/466)and malignant tumor(11.2%,52/466).For PET/CT imaging,95.5%(445/466)of the patients were positive,of which 313(70.3%,313/445)were found to have focal lesions,and the other 132(29.7%,132/445)showed only nonspecific abnormal uptake.Lesions in different types of diseases were varied in the location,morphological changes as well as FDG uptake.The results of the questionnaire showed that PET/CT imaging could benefit 95.9%(447/466)of the patients in the FUO diagnosis and treatment.PET/CT reached direct etiological diagnosis of malignant tumors more frequently than other types of diseases(χ^2 values:14.408-25.466,all P<0.001).PET/CT helped or directly reached the etiological diagnosis of rheumatologic diseases more frequently than infection and unknown cause group(χ^2 values:7.922,9.647,both P<0.05).Conclusion^18F-FDG PET/CT imaging has high clinical value in the diagnosis of FUO etiology and can provide multilevel diagnostic information.

关 键 词：发热 正电子发射断层显像术 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R816[医药卫生—放射医学]