^(18)F-FDG PET/CT与WB-DWI在恶性肿瘤骨转移中的诊断价值比较  

Comparison of the diagnostic value of^(18)F-FDG PET/CT and WB-DWI in malignant tumor bone metastasis

作　　者：宋卫国[1] 李剑凤 武国恩 SONG Weiguo;LI Jianfeng;WU Guo’en(Department of Nuclear Medicine,Qinghai Provincial People’s Hospital,Xining,Qinghai Province 810000,China;Functional Section,Qinghai Welfare Charity Hospital,Xining,Qinghai Province 810007,China)

机构地区：[1]青海省人民医院核医学科,青海西宁810000 [2]青海省福利慈善医院功能科,青海西宁810007

出　　处：《实用放射学杂志》2023年第12期2013-2017,共5页Journal of Practical Radiology

摘　　要：目的比较^(18)F-氟代脱氧葡萄糖(^(18)F-FDG)正电子发射断层显像(PET)/CT与MR全身扩散加权成像(WB-DWI)在恶性肿瘤骨转移中的诊断价值。方法选择100例疑似恶性肿瘤骨转移患者为研究对象,所有患者均于治疗前接受^(18)F-FDG PET/CT、WB-DWI检查。以病理检查及随访结果为金标准,分析2种检查方法在恶性肿瘤骨转移中的诊断价值。结果金标准诊断有93例患者发生骨转移,共232处病灶。^(18)F-FDG PET/CT检查检出率为92.67%,与WB-DWI检出率89.66%比较差异不显著(P>0.05)。^(18)F-FDG PET/CT检查对恶性肿瘤骨转移诊断灵敏度、阳性预测值、诊断符合率分别为92.67%、98.62%、98.71%,均高于WB-DWI检查的89.66%、97.65%、94.83%,但差异无统计学意义(P>0.05);^(18)F-FDG PET/CT检查的特异度、阴性预测值分别为82.35%、45.16%,显著高于WB-DWI检查的70.59%、33.33%(P<0.05)。骨转移患者的最大标准摄取值(SUVmax)明显高于良性病变患者,表观扩散系数(ADC)值明显低于良性病变患者(P<0.05)。受试者工作特征(ROC)曲线分析显示,SUVmax、ADC值联合诊断价值较单一检查更高[曲线下面积(AUC)=0.912,P<0.05]。结论^(18)F-FDG PET/CT检查对恶性肿瘤骨转移的诊断效能高于WB-DWI检查,两者联合检查可提高对恶性肿瘤骨转移的诊断效能。Objective To compare the diagnostic value of^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography(PET)/CT and MR whole body diffusion weighted imaging(WB-DWI)in malignant tumor bone metastasis.Methods A total of 100 patients with suspected malignant tumor bone metastasis admitted were selected as the research objects.All patients underwent^(18)F-FDG PET/CT and WB-DWI before treatment.Pathological examination and follow-up results were used as the gold standard,the diagnostic value of the two examination modalities in malignant tumor bone metastasis was analyzed.Results There were 93 patients with bone metastasis diagnosed by gold standard,with a total of 232 lesions.The detection rate of^(18)F-FDG PET/CT was 92.67%,which was not significantly different from that of WB-DWI(89.66%)(P>0.05).The sensitivity,positive predictive value and diagnostic coincidence rate in malignant tumor bone metastasis of^(18)F-FDG PET/CT were 92.67%,98.62%and 98.71%,respectively,which were significantly higher than 89.66%,97.65%and 94.83%of WB-DWI,but the difference was not significant(P>0.05).The specificity and negative predictive value of^(18)F-FDG PET/CT were 82.35%and 45.16%,respectively,which were significantly higher than 70.59%and 33.33%of WB-DWI(P<0.05).The maximum standardized uptake value(SUVmax)of patients with bone metastasis was significantly higher than that of patients with benign lesions,and the apparent diffusion coefficient(ADC)value was significantly lower than that of patients with benign lesions(P<0.05).Receiver operating characteristic(ROC)curve showed that the diagnostic value of SUVmax combined with ADC[area under the curve(AUC)=0.912,P<0.05]was higher than that of single examination.Conclusion^(18)F-FDG PET/CT is more effective than WB-DWI in the diagnosis of malignant tumor bone metastasis,he combination of the two examinations can improve the diagnostic efficacy for malignant tumor bone metastasis.

关 键 词：正电子发射断层显像 计算机体层成像 磁共振成像 全身扩散加权成像 恶性肿瘤 骨转移 

分 类 号：R814.42[医药卫生—影像医学与核医学] R445.2[医药卫生—放射医学] R738.1[医药卫生—临床医学]