18F-FDG PET/CT参数SUVmax在孤立性肺结节诊断中的应用  

Role of SUVmax in the evaluation of solitary pulmonary nodules using 18F-FDG PET/CT

作　　者：刘永[1] 陈鹏[1] 孙振国 袁小帅 陆武[1] LIU Yong;CHEN Peng;SUN Zhen-guo;YUAN Xiao-shuai;LU Wu(Department of Nuclear Medicine,First People's Hospital of Lianyungang,Lianyungang 222002,Jiangsu,CHINA)

机构地区：[1]连云港市第一人民医院核医学科,江苏连云港222002

出　　处：《海南医学》2020年第19期2525-2528,共4页Hainan Medical Journal

摘　　要：目的探讨不同病理类型的孤立性肺结节(SPN)摄取18F-FDG的差异,以提高SPN定性诊断的准确率。方法回顾性分析连云港市第一人民医院2017年9月至2019年8月收治的103例SPN患者的18F-FDG PET/CT检查资料,测量病灶标准化摄取值最大值(SUVmax),以病理结果为金标准,分析良恶性结节SUVmax差异,通过秩和检验(Mann-Whitney U检验),运用ROC曲线分析良恶性结节SUVmax的最佳临界值及其诊断效能。结果103例SPN患者中恶性病变70例,良性病变33例;70例恶性病变患者的SUVmax为3.95(2.18,8.75),其中46例实性结节SUVmax为7.60(3.73,9.66),24例亚实性结节SUVmax为2.00(1.40,2.73);33例良性病变患者的SUVmax为1.70(0.75,3.45),其中6例亚实性病变SUVmax为1.75(0.84,4.73);恶性病变组患者的SUVmax明显大于良性病变组,差异有统计学意义(P<0.05),而亚实性病变良恶性的SUVmax比较差异无统计学意义(P>0.05);剔除亚实性结节,良性与恶性结节患者的SUVmax ROC曲线下面积为0.781,95%可信区间为0.657~0.905,最佳临界值为1.85;若以1.85为良、恶性诊断界值,灵敏度、特异度、准确率、阴性预测值、阳性预测值分别为97.83%、55.56%、82.19%、93.75%、78.95%。结论不同病理类型孤立性肺结节摄取18F-FDG有明显差别;实性结节应用1.85标准诊断良恶性准确率较高,小于1.85则高度提示良性,大于1.85则怀疑恶性可能;亚实性结节PET/CT SUVmax参数对其良恶性鉴别价值相对较小。Objective To explore the difference of 18F-FDG uptake in different pathological types of SPN,so as to improve the accuracy of qualitative diagnosis of SPN.Methods The data of 103 cases of SPN 18F-FDG PET/CT from September 2017 to August 2019 in First People's Hospital of Lianyungang were analyzed retrospectively.The SUVmax value of lesions was measured.The difference of SUVmax between benign and malignant nodules was analyzed with pathological results as the gold standard.The best critical value and diagnostic efficacy of SUVmax in benign and malignant nodules were discussed by Mann-Whitney U-test and ROC curve analysis of two samples.Results There were 70 malignant lesions and 33 benign lesions in 103 cases of SPN.The SUVmax were 3.95(2.18,8.75)for the 70 cases of malignant lesions,7.60(3.73,9.66)for 46 cases of solid nodules,2.00(1.40,2.73)for 24 cases of sub-solid nodules were.And 1.70(0.75,3.45)were in 33 cases of benign lesions,of which 6 cases of sub-solid lesions 1.75(0.84,4.73).The difference of SUVmax between malignant group and benign group was statistically significant(P<0.05),but the difference between benign and malignant sub-solid groups was not statistically significant(P>0.05).All sub-solid nodules were excluded,the area under SUVmax ROC curve of benign and malignant nodules was 0.781,the 95%confidence interval was 0.657-0.905,and the optimal critical value was 1.85.The sensitivity,specificity,accuracy,negative predictive value and positive predictive value were 97.83%(45/46),55.56%(15/27),82.19%(60/73),93.75%(15/16),78.95%(45/57),respectively,when 1.85 was used as the diagnostic threshold for benign and malignant tumors.Conclusion The uptake of 18F-FDG in solitary pulmonary nodules of different pathological types is significantly different,and malignant nodules are larger than benign ones.The diagnostic accuracy of solid nodules using the 1.85 criterion was higher.Benign nodules were highly suggestive when the diagnostic accuracy was less than 1.85,and malignant nodules were suspected when the di

关 键 词：孤立性肺结节 肺癌 正电子发射断层扫描 18-氟脱氧葡萄糖 标准化摄取值 受试者工作特性曲线 

分 类 号：R734.2[医药卫生—肿瘤]