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FDG PET/CT对经典型不明原因发热的诊断价值

Value of 18F-FDG-PET/CT in diagnosis of classic fever of unknown origin

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【作者】 赵葵董孟杰阮凌翔刘振锋杨树业王国林孙芳

【Author】 ZHAO Kui,DONG Meng-jie,RUAN Ling-xiang,LIU Zhen-feng,YANG Shu-ye,WANG Guo-lin and SUN Fang(PET Center,The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China)

【机构】 浙江大学医学院附属第一医院PET中心

【摘要】 目的:探讨FDG PET/CT在经典型不明原因发热中的诊断价值。方法:对在2007年10月至2009年10月间27例(男性19例,女性8例)经典型不明原因发热病例,行FDG PET/CT显像,PET/CT图像结果判断应用目测法和半定量分析方法。最终诊断包括病理学检查或临床随访。结果:纳入本研究共27例不明原因发热患者,行PET/CT检查后经病理穿刺或病例随访证实,引起不明原因发热的病因共21例,其中包括感染10例,肿瘤性疾病(淋巴瘤)4例,非感染性炎症4例,其他类型3例,未能发现病因6例。FDG PET/CT诊断真阳性21例,假阳性1例,假阴性0例,真阴性5例。灵敏度100%,特异性83.3%;阳性预测值95.5%,阴性预测值100%;准确性96.3%。结论:在诊断不明原因发热患者中,FDG PET/CT显像是灵敏可靠的诊断方法,建议常规检查未能发现病灶或不能确诊的病例,可尽早行FDG PET/CT显像。

【Abstract】 Objective: To evaluate the application of 18F-FDG PET/CT in diagnosis of classic fever of unknown origin.Methods: A total of 27 consecutive patients with classic fever of unknown origin(FUO)(19 men,8 women;aged 24-82 y) underwent 18F-FDG PET/CT scans.The images were interpreted by visual inspection and semiquantitative analysis(standardized uptake value,SUV).Final diagnosis was based on histopathology or clinical follow-up.Results: The cause of FUO was confirmed by followed investigations in 21 of 27 cases after PET/CT scan,including 10 cases of infection,4 of noninfectious inflammation,4 of malignancies and 3 of miscellaneous disorders;and remaining 6 cases were still confirmed FUO.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 100.0%,83.3%,83.3%,100.0% and 96.3%,respectively.Conclusion: For patients with fever of unknown origin,18F-FDG-PET/CT can be a sensitive,reliable imaging modality.It is suggested that 18F-FDG-PET/CT should be considered earlier in detecting the causes of FUO,which is difficultly diagnosed by conventional modalities.

【基金】 浙江省科技厅基金资助项目(2009C33109);浙江省医药卫生基金资助项目(2007A072)
  • 【文献出处】 浙江大学学报(医学版) ,Journal of Zhejiang University(Medical Sciences) , 编辑部邮箱 ,2010年02期
  • 【分类号】R817.4
  • 【被引频次】21
  • 【下载频次】459
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