【作者】 王建方； 赵新明； 张敬勉； 孙莉； 李德志； 戴春暖； 王颖晨； 张召奇； 江志华；

【Author】 Wang Jian-Fang Zhao Xin-Ming Zhang Jing-Mian et al. Department of nuclear medicine, the fourth hospital of Hebei medical university & Hebei provincial tumor hospital, Shijiazhuang, 050011, China

【机构】 河北医科大学第四医院暨河北省肿瘤医院核医学科；

【摘要】 目的:评价18F-FDG符合线路显像对肺内病变的诊断价值。方法:经CT检查发现肺内占位病变患者81例,男 65例,女16例,年龄30-78岁,平均63．53±11．39岁。胸部CT检查后两周内行18F—FDG符合线路检查。胸部CT共发现肺内1cm以上结节112个,其中<3cm的结节42个,> 3cm结节70个,平均大小约为3．55±1．86cm。受检者行符合线路显像检查当日需空腹4—6小时,空腹血糖值在6． 1mmol／L以下。18F—FDG由北京原子高科提供。静脉注射 18F—FDG 1 48—222MBq,嘱受检者安静休息40分钟后上机检查。仪器为西门子1英寸晶体e．camduet型PET／SPECT仪, 仪器质控符合要求。患者取仰卧位,双手抱头,PET／SPECT 仪轴向视野37cm,检查范围包括全肺。矩阵128×128,放大倍数1．0,双探头顺时针旋转,每个探头各旋转360°。采集速度20～25秒／帧,共采集64帧。图像处理行迭代法重建, 获得冠状面-矢状面及横断面图像,图像层厚4．80mm。由2 名有经验的核医学医师共同阅片分析图像,记录病变部位、大小、个数和T／N比值并与病理或临床随访结果做对比分析。结果:122个结节中,经病理或随访证实为恶性的病灶为93 个,良性病灶19个。93个恶性病灶符合线路显像真阳性病灶 88个,假阳性2个,假阴性5个。88个恶性病灶T／N比值为 4．07±2．16。19个良性病变符合线路显像真阴性17个。18F— FDG符合线路显像对肺内恶性病变诊断的灵敏度为94．62％ (88／93);特异性为89．47％(17／19),准确性为93．75％(105／ 112),阳性预测值为97．77％(88／90),阴性预测值为81．71％ (17／22)。93个恶性病灶中CT诊断真阳性80个,假阳性9个, 假阴性13个。19个良性结节中CT诊断真阴性10个。胸部CT 对肺内病变诊断的灵敏度为86．02％(80／93),特异性为52． 63％(10／19),准确性为80．36％(90／112),阳性预测值为89． 89％(80／89),阴性预测值为43．48％(1 0／23)。18F—FDG符合线路显像对肺内结节的诊断的灵敏度、特异性、准确性方面明显高于C1、(x2检验,P<0．05)。结论:18F—FDG符合线路显像对肺内病变诊断的灵敏度和特异性较高,具重要的临床价值。更多还原

【Abstract】 Objective: To study the value of 18F-FDG coincidence imaging in differential pulmonary diseases. Methods: 81 patients with pulmonary diseases(65men, 16 women, average age63.53 ± 11.39years) were studied with 18F-FDG using a coincidence imaging. Meanwhile, all patients received a Computed Tomography (CT) scan in two weeks before 18F-FDG coincidence imaging examination. The coincidence imaging results were analyzed and compared with CT scan. The final diagnosis was confirmed by pathology or clinical following-up. Results: 18F-FDG coincidence imaging showed significantly Increasing FDG uptake in 88 of 93 tumors with proven malignancies and in 2 tumors with benign lesions. FDG imaging had negative findings in 17 tumors with benign lesions and 5 tumors with malignancy. The sensitivity, specificity, accuracy, positive predicative value and negative value of 18F-FDG coincidence imaging were 94.62% (88/93), 89.47%( 17/19 ), 93.75%(105/112), 97.77%(88/90), 81.71% (17/22), respectively. Those of CT scan were 86. 02%(80/93), 52.63% (10/19 ), 80.36%(90/112), 89.89% (80/89), 43.48% (10/23 ), respectively. The 18F-FDG coincidence imaging diagnostic accuracy was significantly higher than CT scan. Conclusions:18F-FDG coincidence imaging has a higher sentivity and specificity than CT scan. It appears to be a powerful imaging tool in differential diagnosis of pulmonary disorders.更多还原