【摘要】 目的探讨18F-FDG PET中联合放射性摄取程度、形态及双时相显像标准摄取值(SUV)改变情况诊断孤立性肺结节(SPN)良恶性的效能。方法回顾性分析64例经病理或临床随诊确诊的SPN患者18F-FDG PET/CT资料。根据SPN放射性摄取程度、形态及双时相显像SUV改变情况制定诊断标准,比较该标准与"2.5标准"(早期显像SUVmax≥2.5诊断为恶性)诊断恶性SPN的灵敏度、特异度、准确率、阳性预测值和阴性预测值。结果按本组标准和"2.5标准"18F-FDG PET诊断恶性SPN的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为85.71%(42/49)、72.73%(8/11)、83.33%(50/60)、93.33%(42/45)、53.33%(8/15)和51.92%(27/52)、75.00%(9/12)、56.25%(36/64)、90.00%(27/30)、26.47%(9/34),灵敏度和准确率二者差异有统计学意义(P均<0.05)。结论 18 F-FDG PET中,联合放射性摄取程度、形态及双时相显像SUV改变情况制定诊断标准可提高鉴别诊断SPN良恶性的准确率,具有一定临床应用价值。更多还原

【Abstract】 Objective To explore the ability of 18F-FDG PET in differential diagnosis of benign and malignant solitary pulmonary nodule(SPN)with comprehensive criterion based on the morphology and degree of 18F-FDG uptake and the change of standardized uptake value(SUV)in dual-phase imaging.Methods 18 F-FDG PET/CT data of 64patients with SPNs confirmed by pathology or follow-up were retrospectively analyzed.The diagnostic criterion of 18F-FDG PET in differential diagnosis of SPNs was designed based on the morphology and degree of 18F-FDG uptake and the change of SUV in dual-phase imaging.The sensitivity,specificity,accuracy,positive and negative predictive value of 18F-FDG PET/CT according to above diagnostic criterion and 2.5criterion(SPN with SUVmax≥2.5was diagnosed as malignant lesion)were calculated and compared.Results The sensitivity,specificity,accuracy,positive and negative predictive value of 18F-FDG PET/CT was 85.71%(42/49),72.73%(8/11),83.33%(50/60),93.33%(42/45),53.33%(8/15)according to the diagnostic criterion designed in this study,and 51.92%(27/52),75.00%(9/12),56.25%(36/64),90.00%(27/30),26.47%(9/34)according to 2.5criterion.There were significant differences of sensitivity and accuracy between the two criterions(both P<0.05).Conclusion Using comprehensive criterion based on the morphology and degree of 18F-FDG uptake and the change of SUV in dual-phase imaging can improve the diagnostic accuracy of benign and malignant SPN,with certain clinical application value.更多还原