18F-FDG-PET/CT特征参数对肾上腺转移瘤和乏脂性腺瘤的鉴别诊断价值  

Value of characteristic parameters in 18F-FDG-PET/CT for differentiation between adrenal metastases and lipid-poor adenomas

作　　者：王乔 曹立秀[1] 刘永亮[2] 王鹏[3] 赵文喆[4] 刘爽 吴会静[1] 姚玉翠 WANG Qiao;CAO Liriu;LIU Yongliang;WANG Peng;ZHAO Wenzhe;LIU Shuang;WUHuijing;YAO Yucui(Department of ECT,Tangshan People's Hostipal,Tangshan,Hebei Province,063000,China)

机构地区：[1]河北省唐山市人民医院ECT室,063000 [2]唐山市人民医院神经外科 [3]唐山市人民医院泌尿外科 [4]唐山市人民医院科教科 [5]唐山市人民医院放化科 [6]唐山市药品不良反应监测中心

出　　处：《中国煤炭工业医学杂志》2023年第6期630-635,共6页Chinese Journal of Coal Industry Medicine

基　　金：2023年度河北省医学科学研究重点课题计划(编号:20231806)。

摘　　要：目的探讨18F-FDG-PET/CT特征参数对肾上腺转移瘤和乏脂性腺瘤的鉴别诊断价值。方法回顾性分析2022年10月—2023年9月在唐山市人民医院行18F-FDG PET/CT检查发现单侧肾上腺高密度结节(转移瘤43例,乏脂性腺瘤42)的85例癌症患者的临床及影像特征参数,包括性别、年龄、原发恶性肿瘤和肾上腺结节的大小、位置、CT值及PET代谢参数。利用单因素分析筛选有统计学差异的特征参数,去掉高相关性变量,后纳入多元Logistic回归构建诊断模型。利用受试者操作特征(ROC)曲线下面积(AUC)评估各独立风险因素和诊断模型预测肾上腺转移瘤的效能,并通过delong分析比较其AUC差异。结果肾上腺结节的平扫CT值、SUVmax和原发恶性肿瘤是预测肾上腺转移瘤的独立风险因素,其中平扫CT值鉴别诊断效能最高(AUC为0.803)。诊断模型的预测效能进一步提高,AUC为0.905,显著高于各独立危险因素(P均<0.05);且通过随机抽样进一步验证了该诊断模型的准确性及稳定性。结论基于18F-FDG PET/CT诊断模型对肾上腺转移瘤和乏脂性腺瘤有较高的鉴别诊断效能,为肾上腺高密度结节提供了一种无创、高效、便捷的诊断方法。Objective To explore the value of characteristic parameters in 18F-FDG-PET/CT for the differentiation between adrenal metastases and lipid-poor adenomas.Methods The clinical and metabolic parameters of eighty-five patients(adrenal metastases 43,lipid-poor adenomas 42)with unilateral adrenal hyperattenuating nodules found by 18F-FDG PET/CT in Tangshan People's Hospital from October 2022 to June 2023 were analyzed,including gender,age,the primary malignant tumor,and the size,location,CT values,and PET metabolic parameters of the adrenal nodules.Parameters with statistical differences were selected by univariate analysis,highly correlated variables were delated,and then a diagnostic model was constructed by multiple logistic regression.The receiver operating characteristic curves was used to evaluate the differential diagnostic performance of independent risk factors and diagnostic model,and the areas under the receiver operating characteristic curves(AUCs)differences were compared by delong analysis.Results The CT value in plain scan,SUVmax of adrenal nodules,and the primary malignant tumor are independent risk factors for predicting small metastases.Among them,plain scan CT value was the most valuable independent risk factor for differential diagnosis,with the highest diagnostic performance(AUC of 0.803).The diagnostic performance of the predictive model was further improved,with an AUC of 0.905,significantly higher than that of individual independent risk factors(P all<0.05).And the accuracy and stability of the diagnostic model were further verified through random sampling.Conclusion The predictive model established based on 18F-FDG PET/CT features has high diagnostic performance for differentiating adrenal metastases and lipid-poor adenomas,providing a non-invasive,efficient,and convenient diagnostic method for hyperattenuating adrenal nodules.

关 键 词：肾上腺转移瘤 肾上腺乏脂性腺瘤 18F-FDG-PET/CT 诊断模型 

分 类 号：R871[医药卫生—运动医学]