【摘要】 目的探讨18F-FDG PET-CT双时相显像联合同机HRCT对肺内孤立单纯性磨玻璃结节的诊断与鉴别诊断价值。方法回顾性分析38例肺孤立单纯性磨玻璃样结节(28例恶性,10例良性)的HRCT征象及18F-FDG PET/CT常规显像最大标准摄取值(SUVmax)、双时相显像滞留指数(RI)、双时相显像基于最大标准摄取值的肿瘤本底比值(T/N)的变化率(△T/Nmax),分别分析不同标准对肺孤立性单纯性磨玻璃结节的诊断效能,将诊断效能最好的指标与HRCT相联合分析其诊断效能;统计学方法采用SPSS 13.0软件。结果 HRCT对肺孤立性单纯性磨玻璃结节的诊断敏感性、特异性、准确性分别为88.5%、50%、76.3%。良恶性肺孤立性单纯性磨玻璃结节常规显像与延迟显像的SUVmax、RI及△T/Nmax之间差异均有明显统计学意义。以SUVmax≥1.0为评判指标对单纯性磨玻璃结节的诊断敏感性、特异性、准确性分别为75.0%、90.0%、78.9%。以RI≥5%为评价标准,其诊断敏感性、特异性、准确性分别为50%、90%、60.5%。△T/Nmax≥5%为评判标准的诊断敏感性、特异性、准确性分别为71.4%、90.0%、76.3%。常规显像SUVmax≥1.0联合HRCT、△T/Nmax≥5%联合HRCT,在特异性保持不变的情况下,对肺孤立性单纯性磨玻璃结节的诊断敏感性及准确性均有所提高,分别为89.3%和89.5%、85.7%和86.8%。结论对于肺内孤立单纯性磨玻璃结节,SUVmax≥1.0、△T/Nmax≥5%具有更高的临床诊断效能。将两者与同机HRCT相联合可以提高诊断敏感性及准确性。更多还原

【Abstract】 Objective To evaluate18F- FDG PET- CT double- phase imaging combined with same scanner HRCT in the diagnosis and differentiation of pulmonary solitary simple ground glass nodules. Methods A total of 38 patients with pulmonary solitary simple ground glass nodules,including malignant nodules( n = 28) and benign nodules( n = 10),were included in this study. The imaging manifestations,including HRCT findings,the maximum standard uptake value(SUVmax) of conventional18F- FDG PET- CT imaging,the double- phase imaging retention index( RI),the change rate of double- phase imaging SUVmaxof tumor to background( △T / Nmax) were calculated. The diagnostic efficacy estimated by different standards for pulmonary solitary simple ground glass nodules was separately analyzed,and the indexes carrying the best diagnostic efficacy were combined with HRCT to statistically analyze its diagnostic effecacy by using SPSS 13. 0software. Results The diagnostic sensitivity,specificity and accuracy of HRCT for pulmonary solitary simple ground glass nodules were 88. 5%,50% and 76. 3% respectively. Statistically significant differences in SUVmax,RI and △T/Nmax of conventional imaging and delayed imaging existed between the benign and malignant pulmonary solitary simple ground glass nodules. Taking SUVmax≥1. 0 as the standard reference,the diagnostic sensitivity,specificity and accuracy for pulmonary solitary simple ground glass nodules were 75. 0%,90% and 78. 9% respectively; when taking RI ≥5% as the standard reference,the diagnostic sensitivity,specificity and accuracy for pulmonary solitary simple ground glass nodules were 50%,90% and 60. 5% respectively; if △T / Nmax≥5% was used as the standard reference,the diagnostic sensitivity,specificity and accuracy for pulmonary solitary simple ground glass nodules were 71. 4%,90. 0% and 76. 3% respectively. Combination use of conventional imaging SUVmax≥1. 0 and HRCT and combination use of conventional imaging△T/Nmax≥5% and HRCT,if the specificity remained unchanged,the diagnostic sensitivity and accuracy for pulmonary solitary simple ground glass nodules could be improved up to 89. 3% and 89. 5%; 85. 7% and 86. 8% respectively.Conclusion For the diagnosis of pulmonary solitary simple ground glass nodules,SUVmax≥1. 0 and △T/Nmax≥5% are more reliable. The combination of SUVmax≥1. 0 and △T/Nmax≥5% with HRCT can improve the diagnostic sensitivity and accuracy.更多还原