18F-FDG符合线路SPECT/CT对肺孤立性病变的诊断价值

摘要

Objective : The aim is to explore the clinical value of 18 F-fluorodeoxyglucose (18 F-FDG) coincidence detection imaging for solitary pulmonary mass using semi-quantitative analysis of SPECT/CT CoDe imaging. Methods : Seventyfour cases of solitary pulmonary mass,which were confirmed by pathologic findings or follow-up,were checked by 18 F-FDG SPECT/CT CoDe imaging. The findings of 18 FFDG metabolic images were analyzed in semi-quantitative ways. Regions of interest (ROI) were placed over the mass (T) and normal soft tissue (NT) ,and T/NT value was calculated. Results: Of the 74 cases,49 were true positive cases,16 true negative cases,7 false positive and 2 false negative according to T/NT≥3.5 threshold. A sensitivity of 96.08％ ,a specificity of 69.57 ％ ,and an accuracy of 87.84％ were found for detection of pulmonary neoplasm. The positive prediction value (PPV) and negative prediction value (NPV) were 87.50％ and 88.89％ , respectively. The 18 F-FDG uptaking value in malignant disease was higher than in benign lesions ( P＜0.05) . Conclusion : Semiquantitative analysis of SPECT/CT CoDe imaging is of important clinical value in early detection, differential diagnosis and prognosis evaluation for solitary pulmonary mass.%目的:应用18F-脱氧葡萄糖(18F-FDG)符合线路SPECT/CT显像半定量分析,探讨符合线路SPECT/CT对肺部孤立性病变的诊断价值.方法:回顾性分析经病理或随访证实的74例肺孤立性病变患者的18F-FDG符合线路SPECT/CT图像,用半定量法(计算病灶组织与周围正常软组织的摄取比值,即T/NT)测量,所得数据进行统计学分析.结果:半定量分析显示恶性病变摄取18F-FDG比值(9.57±6.13)明显高于良性病变(2.99±1.59),差异有统计学意义(P<0.05).以T/NT≥3.5作为恶性病变的判定标准,74例肺孤立性病变中,真阳性49例,真阴性16例,假阳性7例,假阴性2例.敏感度、特异度、准确率、阳性预测值和阴性预测值分别为96.08%、69.57%、87.84%、87.50%和88.89%.结论:18F-FDG符合线路SPECT/CT显像对肺孤立性病变的诊断、鉴别诊断及预后评估具有重要的临床应用价值.