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18F-FDG PET/CT在良恶性胰腺囊性病变中的诊断价值

The Value of 18F-FDG PET/CT in Differentiating Benign from Malignant Pancreaticcystic Lesions

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【作者】 张晓春王思云王秋实王淑侠

【Author】 ZHANG Xiao-chuna;WANG Si-yuna;WANG Qiu-shib;WANG Shu-xiaa;Department of Nuclear Medicine,Guangdong General Hospital,Guangdong Academy of Medical Sciences;Department of Radiology,Guangdong General Hospital,Guangdong Academy of Medical Sciences;

【机构】 广东省人民医院广东省医学科学院核医学科广东省人民医院广东省医学科学院放射科

【摘要】 目的评价18F-FDG PET/CT鉴别良恶性胰腺囊性病变的能力。方法回顾2008年7月至2016年3月行18F-FDG PET/CT成像的胰腺囊性病变患者的数据。测量病变的大小及标准化摄取值SUVmax。用SPSS19.0软件进行统计学分析。结果共获得患者55例。良性病变29例,恶性病变23例,交界性病变3例。对于直径<3 cm病变,良恶性病变SUVmax间的差异没有统计学意义[(2.91±2.08)vs.(2.48±1.10),P=0.601]。对于直径≥3 cm病变,良恶性病变SUVmax间的差异有统计学意义[(2.71±2.06)vs.(6.56±3.95),P=0.001]。以SUVmax=3.0作为阈值,18F-FDG PET/CT对37例直径≥3 cm胰腺囊性病变诊断的敏感度、特异度、阳性预测值、阴性预测值、准确度分别为89%、84%、84%、89%、86%。结论 18F-FDG PET/CT用于良性与恶性胰腺囊性病变的鉴别时,对于直径<3 cm病变无鉴别价值,对于直径≥3 cm病变有较好的鉴别价值。

【Abstract】 Objectives To evaluate the diagnostic capability of 18F-FDG PET/CT in differentiating benign from malignant pancreaticcystic lesions. Methods Between July 2008 and March 2016,all patients with pancreatic cystic lesions that had 18F-FDG PET/CT were reviewed. The sizes and maximum standardized uptake values(SUVmax)of the pancreatic cystic lesions were measured. The definition of the gold standard was based on histopathologic findings(n=52)and operative findings without biopsy(n=1)and percutaneous biopsy(n=2). All statistical analyses were performed using SPSS 19.0. Results A total of 55 patients with pancreatic cystic lesions were enrolled for the study. Of all patients,29 had benign lesions but 26 were assigned to the malignant group(23 with malignant neoplasms,3 with borderline neoplasms).18 patients had cystic lesions that were smaller than 3 cm in diameter(8 with malignant neoplasms,10 with benign lesions),and 37 patients had cystic lesions 3 cm in diameter or bigger(18 with malignant neoplasms,19 with benign lesions). For lesions that was smaller than 3 cms in the diameter,SUVmax between malignant and benign lesions were of no statistical difference[(2.91±2.08)vs.(2.48±1.10),P=0.601]. For lesions that was 3 cm in the diameter or bigger,SUVmax was significantly higher in malignant than in benign lesions[(2.71 ± 2.06)vs.(6.56 ± 3.95),P=0.001]. The optimal cut off value of SUVmax for differentiating benign from malignant pancreatic cystic lesions was 3.0,which wasdetermined by receiver-operating- characteristic analysis using the highest Youden index. For all of the lesions,sensitivity,specificity,positive and negative predictive values,and accuracy of 18F-FDG PET/CT indetecting malignant cystic lesions were 65%,79%,74%,72% and 73%,respectively. For 37 lesions that was 3 cm s in the diameter or bigger,sensitivity,specificity,positive and negative predicti vevalues,and accuracy of 18F-FDG PET/CT indetecting malignant cystic lesions were 89%,84%,84%,89% and 86%,respectively. Conclusion 18F-FDG PET/CT is an accurate imaging modality for differentiating between benign and malignant pancreatic cystlesions that were 3 cm in the diameter or bigger,and which is not accurate for lesions that were smaller than 3 cm in the diameter.

【关键词】 18F-FDG PET/CT胰腺囊性病变诊断
【Key words】 18F-FDG PET/CTpancreaticcystic lesionsdiagnosis
【基金】 广东省医学科学技术研究基金资助项目(A2016412)
  • 【文献出处】 循证医学 ,The Journal of Evidence-Based Medicine , 编辑部邮箱 ,2016年06期
  • 【分类号】R735.9;R730.44
  • 【被引频次】2
  • 【下载频次】68
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