^(18)F-FDG PET/CT对非肿瘤性疾病导致不明原因发热的诊断价值  

Diagnostic Value of ^(18)F-FDG PET/CT in Fever of Unknown Origin Caused by Non-Neoplastic Diseases

作　　者：常冰洁 刘加成[2] 吴嘉钰 牟琦 CHANG Bingjie;LIU Jiacheng;WU Jiayu;MU Qi(Department of Nuclear,ZhongDa Hospital Southeast University,Nanjing 210000,China;不详)

机构地区：[1]东南大学,江苏南京210000 [2]东南大学附属中大医院核医学科,江苏南京210000

出　　处：《中国医学影像学杂志》2023年第8期882-886,共5页Chinese Journal of Medical Imaging

摘　　要：目的 评价^(18)F-FDG PET/CT对非肿瘤性疾病导致的不明原因发热(FUO)的诊断价值。资料与方法 回顾性分析东南大学附属中大医院2017年9月—2021年12月以FUO就诊的79例患者的^(18)F-FDG PET/CT检查结果,患者均基于临床诊断等做出最终诊断,评价^(18)F-FDG PET/CT对感染性疾病及风湿免疫性疾病的诊断贡献。结果 79例FUO患者最终确诊71例(89.9%),其中感染性疾病47例(59.5%),风湿免疫性疾病21例(26.6%),结节病1例(1.3%),药物热1例(1.3%),脂膜炎1例(1.3%)。^(18)F-FDG PET/CT诊断为真阳性56例(70.9%),总体诊断敏感度为88.9%、特异度为44.8%、准确度为79.7%、阳性预测值为86.2%、阴性预测值为50.0%。FUO病因类别为感染性疾病(χ^(2)=4.03,P=0.045)或风湿免疫性疾病(χ^(2)=5.64,P=0.018)与^(18)F-FDG PET/CT的诊断贡献显著相关。结论 ^(18)F-FDG PET/CT可作为非侵入性检查,为非肿瘤性疾病导致FUO的临床诊断提供重要参考价值。Purpose To evaluate the diagnostic value of 18F-FDG PET/CT in fever of unknown origin(FUO)caused by non-neoplastic diseases.Materials and Methods A total of 79 patients with diagnosis of FUO from September 2017 to December 2021 were retrospectively enrolled in ZhongDa Hospital Southeast University.Final diagnosis was performed based on the clinical diagnosis to evaluate the diagnostic contribution of infectious diseases and immune rheumatism via 18F-FDG PET/CT.Results Of 79 patients with FUO,71(89.9%)patients were finally made a definite diagnosis,including 47(59.5%)patients with infectious diseases,21(26.6%)with immune rheumatism,1(1.3%)with sarcoidosis,1(1.3%)with drug fever and 1(1.3%)with panniculitis.A total of 56(70.9%)patients were true positive via 18F-FDG PET/CT.The sensitivity,specificity and accuracy of 18F-FDG PET/CT were 88.90%,44.80%and 79.70%,the positive predictive value was 86.20%,and the negative predictive value was 50.00%,respectively,to make correct diagnosis in patients with FUO.Etiological category of FUO were the infectious diseases(χ^(2)=4.03,P=0.045)and rheumatic diseases(χ^(2)=5.64,P=0.018),respectively,with significant relationship with diagnostic contribution of 18F-FDG PET/CT.Conclusion The 18F-FDG PET/CT can invasively provide important reference value in the diagnosis of FUO caused by non-neoplastic diseases in clinical practice.

关 键 词：原因不明发热 非肿瘤性疾病 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 诊断 鉴别 

分 类 号：R441.3[医药卫生—诊断学] R445.5[医药卫生—临床医学]