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作 者:曾冬梅[1] 李文宇 陈杰[1] ZENG Dongmei;LI Wenyu;CHEN Jie(Dept.of Nuclear Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)
机构地区:[1]武汉大学中南医院核医学科,湖北武汉430071
出 处:《武汉大学学报(医学版)》2023年第5期563-566,570,共5页Medical Journal of Wuhan University
摘 要:目的:探讨不同病理类型的孤立性实性肺结节(SPN)摄取^(18)F-FDG的差异,以提高SPN定性诊断的准确率。方法:回顾性选取武汉大学中南医院2021年1月至2022年1月期间53例孤立性实性肺结节患者作为研究对象,所有患者均进行了^(18)F-FDG PET/CT显像及经手术病理确诊。测量病灶不同的PET代谢参数,包括:SUVmax、SUVmin、SUVavg、SUVpeak、MTV及TLG,以病理结果为金标准,分析各种参数判断结节良恶性及不同病理类型的最佳临界值及效能。结果:53例SPN患者中,恶性病变40例(其中腺癌33例,鳞癌6例,小细胞肺癌1例),良性病变13例。恶性病变组的SUVavg、SUVpeak高于良性病变组,差异具有统计学意义(P<0.05)。在良恶性病变诊断效能上,SUVmax、SUVavg及SUVpeak对恶性病变具有诊断价值(AUC=0.700,0.714,0.714)。在恶性病变中,SUVmax、SUVavg、SUVpeak及TLG对腺癌具有诊断价值(AUC=0.785,0.793,0.785,0.758),且特异性均为100%。结论:充分利用^(18)F-FDG PET/CT不同代谢参数可提高SPN的诊断准确率,其中SUVavg和SUVpeak在鉴别SPN良恶性及恶性病变病理类型上具有重要的价值。Objective:To investigate the difference of ^(18)F-FDG uptake in different pathological types of solitary solid pulmonary nodules(SPNs)in order to improve the accuracy of qualitative diagnosis of SPN.Methods:A total of 53 cases of SPNs confirmed by pathology and examined by ^(18)F-FDG PET/CT in our hospital from January 2021 to January 2022 were selected as the research objects.Different metabolic parameters(SUVmax,SUVmin,SUVavg,SUVpeak,MTV,and TLG)of the lesions were measured.Compared with the pathological results as the gold standard,and through Mann Whitney U test,the optimal critical values and diagnostic efficacy of benign and malignant nodules and different pathological types were analyzed.Results:There were 40 malignant lesions in 53 patients with SPN,including 33 cases of adenocarcinoma,6 cases of squamous cell carcinoma,1 case of small cell lung cancer,and 13 cases of benign lesions.The SUVavg and SUVpeak in malignant lesion group were higher than those in benign lesion group,and the difference was statistically significant(P<0.05).In terms of diagnostic efficacy of benign and malignant lesions,SUVmax,SUVavg and SUVpeak had diagnostic value for malignant lesions(AUC=0.700,0.714,0.714).In malignant lesions,SUVmax,SUVavg,SUVpeak,and TLG had diagnostic value for adenocarcinoma(AUC=0.785,0.793,0.785,and 0.758,respectively),and the specificity was 100%.Conclusion:The diagnosis of SPN is important and difficult in medical imaging,including PET/CT.Adequately application of different metabolic parameters of ^(18)F-FDG PET/CT may improve the diagnostic accuracy of SPN.SUVavg and SUVpeak are of great value in differentiating benign and malignant SPNs and the pathological types of malignant lesions.
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