【摘要】 目的:不明原因胸腔积液病因的诊断是临床治疗的前提,本研究探讨18F-脱氧葡萄糖(FDG)PET/CT显像在病因诊断中的价值。方法:对43例原因未明的胸腔积液患者行18F-FDGPET/CT全身显像。结合PET和CT图像进行综合判断,PET结果的判断采用目测法和标准摄取值(SUV)测定。结果:恶性胸腔积液26例,良性17例(结核性7例,炎性6例,心源性4例)。26例恶性者中,21例PET/CT检出原发病灶,5例未找到原发病灶;6例炎性者PET/CT诊断明确;7例结核性中5例经PET/CT检查诊断明确,另2例误诊为恶性;心源性4例PET/CT检查阴性。18F-FDGPET/CT对不明原因胸腔积液病因诊断的灵敏度80.8%(21/26),特异性为88.2%(15/17),阳性预测值为91.3%(21/23),阴性预测值为75.0%(15/20)。结论:18F-FDGPET/CT可用于不明原因胸腔积液的病因诊断,并有较高的诊断准确率。更多还原

【Abstract】 Purpose:To evaluate the clinical value of 18F-FDG PET/CT to detect the primary tumor in patients with unexplained pleural effusion.Methods:Forty-three patients with unexplained pleural effusion were undergone whole-body 18F-FDG PET/CT.The images were interpreted by visual inspection and semi-quantitative analysis(standardized uptake value,SUV).And the results were analyzed by the combination of PET and CT.Results:According to the results of follow-up and pathology,twenty-six of 43 patients were confirmed malignant pleural effusion,and the others were caused by benign lesion(7 cases of tuberculosis,6 cases of inflammation,4 cases of cardiac disease).The primary lesions were confirmed in twenty-one cases of the patients with unexplained pleural effusion by PET/CT,but still 5 patients were unknown.Six patients with inflammatory pleural effusion were confirmed by PET/CT.Five of 7 patients with tuberculous pleural effusion were diagnosed accurately,while the other two were misdiagnosed for malignant disease.The result of PET/CT scan were negative in four patients with pleural effusion caused by cardiac disease.The sensitivity,specificity,positive predictive value,negative predictive value of 18F-FDG PET/CT in detecting the primary cause of unexplained pleural effusion were 80.8%(21/26),88.2%(15/17),91.3%(21/23) and 75.0%(15/20).Conclusions:18F-FDG PET/CT can be used in etiological diagnosis of unexplained pleural effusion,and has a high diagnostic accuracy.更多还原