11C-胆碱与18F-FDG双时相PET/CT显像结合高分辨率CT在孤立性肺结节鉴别诊断中的应用

目的比较11C-胆碱（11C-CHO）PET/CT、18F-FDG双时相PET/CT、常规18F-FDG PET/CT、11C-CHO+18F-FDG双时相PET/CT显像结合高分辨率CT（HRCT）4种方法对鉴别诊断孤立性肺结节（SPN）良恶性的价值。方法对28例SPN患者进行18F-FDG PET/CT显像（注药后l h显像,2 h行延迟显像）和11C-CHO PET/CT显像（于注药10 min后进行）。PET图像判断以SPN最大截面勾画ROI,计算SUV_max作为半定量指标,SUV_max ≥ 2.5为阳性,18F-FDG PET/CT延迟显像SUV_max上升10%为恶性病变（阳性）,下降或升高 < 10%为良性病变（阴性）。HRCT以是否有分叶征、短细毛刺、胸膜尾征、支气管充气征、血管集束征、空泡征为分析良恶性的指征。所有病例进行临床综合分析及随访,以影像诊断是否符合临床随访及病理结果作为判断标准。组间SUV_max的比较采用t检验;计数资料的比较采用χ2检验。结果 28例SPN患者中,病理或临床随访诊断发现肺癌17例,结核7例,结节病4例。常规18F-FDG PET/CT显像确诊21例,18F-FDG双时相PET/CT显像确诊24例,11C-CHO PET/CT显像确诊23例,11C-CHO +18F-FDG双时相PET/CT+HRCT确诊27例。28例患者良恶性结节的18F-FDG及11C-CHO PET/CT的SUV_max比较,差异有统计学意义（t=10.57和13.19,均P < 0.05）。良恶性结节分叶、毛刺、胸膜尾征、血管集束征之间的差异有统计学意义（χ2=9.27、10.36、14.31和17.52,均P < 0.05）。11C-CHO+18F-FDG双时相PET/CT+HRCT联合显像的灵敏度为81.8%,特异度为94.1%,准确率为96.4%,明显高于非联合显像。结论 11C-CHO+18F-FDG双时相PET/CT+HRCT能较好地鉴别SPN的良恶性,三者联合能提高对SPN的诊断率。     

18F-FDG PET/CT显像联合HRCT对孤立性原发肺浸润性黏液腺癌的诊断价值

目的探讨孤立性原发肺浸润性黏液腺癌18F-FDG PET/CT显像和HRCT征象及两者联合对该病的诊断价值。方法回顾性分析经病理证实为浸润性黏液腺癌、有18F-FDG PET/CT双时相显像及病灶层面同机HRCT扫描资料的9例患者,对PET/CT早期、延迟显像及滞留指数、HRCT征象进行综合分析。结果HRCT图像上表现为2例呈实性结节、病灶周围无类似卫星灶样影,6例实性结节周围伴小点片及磨玻璃样影,1例为单纯磨玻璃样结节;分叶征(6例)、血管集束征(6例)、支气管充气征(4例)、空泡征(2例)、毛刺征(1例);18F-FDG PET/CT融合图像上8例病灶表现为不均匀FDG代谢增高,早期显像平均SUVmax为3.2±2.5,延迟现象SUVmax增高6例、降低2例,平均SUVmax为3.5±2.4,平均滞留指数为(10.4±29.3)%,9例均未见纵隔、双侧肺门淋巴结及其他部位转移征象,其18F-FDG PET/CT融合图像上18F-FDG摄取与HRCT相匹配,18F-FDG摄取相对集中于结节的实性区域,病灶磨玻璃区18F-FDG摄取不明显;综合手术病理结果等临床资料证实,9例均为T1N0M0期,与PET/CT分期一致。结论对于影像学检查发现肺孤立性占位患者,在单一影像学检查难以明确诊断的情况下,18F-FDG PET/CT双时相显像上病灶不均匀18F-FDG摄取相对集中于其实性区域的代谢方式与HRCT相联合,可辅助孤立性原发性肺浸润性黏液腺癌的诊断。     

18F-FDG PET/CT结合高分辨率CT对孤立性肺结节的

 目的 探讨18F-FDG PET/CT显像结合高分辨率CT(high resolution CT,HRCT)对孤立性肺结节(solitary pulmonary nodule,SPN)的诊断价值。方法 回顾性分析124例SPN患者的18F-FDG PET/CT检查资料,其中76例加做HRCT扫描,所有病例经病理或临床随访证实。18F-FDG PET/CT通过目测法和半定量法判断病灶的代谢情况,结合CT或HRCT病灶的形态学特征判断良、恶性。结果 48例仅行18F-FDG PET/CT检查的SPN患者,正确诊断32例为恶性,8例为良性,假阳性与假阴性各4例。76例加做HRCT的患者,正确诊断62例恶性与8例良性,假阳性与假阴性分别为2例和4例。18F-FDG PET/CT 结合HRCT与单纯18F-FDG PET/CT诊断SPN的灵敏度、特异性及准确率分别为94%、80%、90%与89%、67%、83%。结论 18F-FDG PET/CT协同HRCT可提高对SPN性质判断的灵敏度、特异性及准确率。     

18F-FDG PET/CT和同机CT增强扫描对肺硬化性血管瘤的诊断价值

目的 探讨肺硬化性血管瘤(PSH)的18F-FDG PET/CT显像和CT增强扫描特征及2种方法对该病的诊断价值.方法 回顾性分析2007年6月至2011年6月间,经病理证实为PSH、有同机18 F-FDG PET/CT双时相(早期、延迟)显像、病灶层面高分辨率(HR) CT扫描及多期增强CT扫描资料的5例患者,其中女4例,男1例,发病年龄39 ～66(平均51.6)岁.对PET/CT早期、延迟显像图及滞留指数,CT扫描的增强净增值、峰值下降时间及“边缘血管征”等进行综合分析.结果 PSH在双时相18 F-FDG PET/CT显像上表现为斑片样FDG代谢增高,早期显像SUVmax为3.3±1.1,延迟显像SUVmax增高或降低,平均为3.4±1.4,平均滞留指数为(2.1±20.8)％;HRCT可表现为边界清晰的圆形或类圆形结节或肿块,部分可见“空气新月征”,少数病灶内可见钙化点;多期CT增强扫描显示病灶呈中～高度强化(增强净增值为35 ～ 59 HU),增强后峰值下降(峰值下降时间为140～260 s),5例病例均可见1～4条数量不等的“边缘血管征”.结论 PSH 18F-FDG PET/CT显像的肿块或结节的斑片样高代谢表现提示其可能为良性病灶;结合病灶层面的诊断性CT扫描(包括增强)表现,可进一步明确PSH的诊断.     

~(18)F-FDG PET-CT和双源CT的LungCare软件在评估孤立性肺结节中的比较研究

目的 探讨18-氟-脱氧葡萄糖(~(18)F-FDG)PET/CT显像及Siemens双源CT的LungCare软件对孤立性肺结节(SPN)的辅助诊断能力及适用范围.方法 回顾分析经病理证实的24例SPN患者的PET-CT图像资料,并与利用双源CT的LungCare软件分析SPN进行比较研究.用χ~2检验对2种检查方法的评价结果进行统计学分析,以P<0.05作为差异有显著意义.结果 在24例SPN中,恶性结节15例,良性结节9例.LungCare软件评估其良恶性的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为83.3%、80.0%、88.8%、92.3%、72.7%,PET-CT评估其良恶性的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为87.5%、93.3%、77.7%,87.5%、87.5%.LungCare软件和PET/CT定性SPN的准确性相当,两者之间并不存在明显的差异(P>0.05).PET/CT的敏感性、阴性预测值明显高于LungCare软件,但其特异性、阳性预测值明显低于LungCare软件(P<0.05).结论 ~(18)F-FDG PET-CT对肺结节的诊断有一定辅助作用,适用于对孤立性肺结节的良恶性鉴别诊断.PET/CT密切结合LungCare软件,可进一步提高诊断正确率.     

PET-CT显像在结肠直肠癌术后复查的临床应用

目的:评价18F-脱氧葡萄糖(FDG)PET-CT显像与CT扫描在诊断结肠直肠癌术后转移与否的准确性。方法:20例临床可疑(血清癌胚抗原(CEA)升高或CT显像阳性或可疑)结肠直肠癌术后转移的患者行全身18F-FDG PET-CT显像,PET-CT显像结果与CT扫描结果对比分析。结果:20例患者共有病灶27个,病理组织学结果及临床随访结果证实,20个恶性病灶,7个良性病灶。PET-CT显像的阳性预测值为94.7%,阴性预测值为75%,CT扫描结果的阳性预测值为81.3%,阴性预测值为36.3%,两者有显著性差异。结论:全身18F-FDG PET-CT显像在诊断结肠直肠癌术后转移与否的准确性高于比CT扫描结果。     

18F-氟脱氧葡萄糖PET-CT与99mc-亚甲基二膦酸盐骨显像诊断转移性骨肿瘤的对比研究

目的 探讨18F-氟脱氧葡萄糖(18F-FDG)PET-CT与唧99mTc-亚甲基二膦酸盐(99mTc-MDP)全身骨显像对转移性骨肿瘤的诊断价值.方法 93例经病理证实为恶性肿瘤的患者同时接受18F-FDG PET-CT和99mTc-MDP全身骨显像(时间间隔在1周之内),对比分析两种显像结果,骨转移的诊断通过随访2年,由病理、X射线片、CT或MRI检查结果综合决定.结果 93例恶性肿瘤患者中,经过2年随访或病理证实骨转移44例,其中18F-FDG PET-CT灵敏度、特异度和准确率分别为95.4%、91.8%和93.5%,99mTc-MDP全身骨显像分别为90.9%、63.3%和76.3%.18F-FDG PET-CT对转移性骨肿瘤诊断的灵敏度与99mTc-MDP全身骨显像相近,但特异度(t=2.53,P＜0.05)和准确率t=2.47,P＜0.05)均明显高于99mTc-MDP全身骨显像.结论 PET-CT对转移性骨肿瘤有较高的诊断价值.     

18F-FDG PET-CT在霍奇金淋巴瘤疗效评价中的临床价值

目的 探讨18F-FDG PET-CT在霍奇金淋巴瘤(HL)疗效评价中的临床价值.方法 回顾性分析31例HL患者化疗后的18F-FDG PET-CT图像资料,最终结果经病理和临床随访证实,并与治疗后单纯CT结果进行对比分析,采用四格表x2进行差异的显著性检验.结果 ①31例患者共发现病灶145处,其中恶性94处、良性51处.18F-FDG PET-CT评价HL治疗效果的灵敏度、特异度、阳性预测值、阴性预测值及准确率分别为97.87％、94.12％、96.84％、96.00％和96.55％,均明显优于单纯CT检查(x2=9.83、13.49、11.50、11.69、22.58,P均＜0.05).②31例患者经PET-CT显像后,16例(51.61％)更改治疗方案.结论 18F-FDG PET-CT是HL疗效监测的有效手段.     

18F-FDG双时相及18F-FDG联合11C-CHO PET/CT多模态显像在原发性肝细胞肝癌中的诊断价值

目的 探讨18F-氟脱氧葡萄糖(FDG) PET/CT双时相显像及18F-FDG联合11C-胆碱(CHO) PET/CT多模态显像对原发性肝细胞肝癌(HCC)的诊断价值。 方法 回顾性分析2016年3月至2018年12月于内蒙古医科大学附属医院就诊的临床疑似原发肝占位性病变的73例患者的临床资料,其中男性41例、女性32例,年龄58~72岁;47例患者行18F-FDG PET/CT双时相显像,26例患者行18F-FDG联合11C-CHO PET/CT多模态显像。分别测量并计算每个病变的最大标准化摄取值(SUV_max)、肝本底SUV_max、肿瘤SUV_max/肝本底SUV_max比值（T/L）。以病变良恶性为状态变量,分别以18F-FDG、18F-FDG延迟、18F-FDG双时相的SUV_max和18F-FDG、11C-CHO、18F-FDG联合11C-CHO的SUV_max为检验变量绘制受试者工作特征(ROC)曲线并进行两两比较,以组织病理学检查或临床随访结果为“金标准”,对比分析各种显像方法的诊断效能。计量资料的比较采用配对t检验;采用Z秩和检验比较各组间ROC曲线的差异。 结果 （1）18F-FDG PET/CT双时相显像:47例患者共检出49个病变（其中32个为高代谢病变）,经组织病理学检查或临床随访结果证实,40个为HCC（高分化8个、中低分化32个）,9个为良性病变。中低分化HCC的病变SUV_max、肝本底SUV_max和T/L的差异均有统计学意义（t=4.51、?2.53、4.80,均P<0.05）;高分化HCC的病变SUV_max和T/L的差异均有统计学意义（t=2.76、2.62,均P<0.05）;良性病变SUV_max的差异无统计学意义（t=0.00,P>0.05）。18F-FDG PET/CT显像分别与其延迟显像、双时相显像的SUV_max的ROC曲线间的差异均有统计学意义（Z=2.315、2.376,均P<0.05）;而延迟显像与双时相显像的SUV_max的ROC曲线间的差异无统计学意义（Z=0.252,P>0.05）。(2) 18F-FDG联合11C-CHO PET/CT显像:26例患者共检出26个病变（其中18个为高代谢病变）,经组织病理学检查或临床随访证实,22个为HCC（高分化9个、中低分化13个）,4个为良性病变。高分化HCC的病变SUV_max、肝本底SUV_max间的差异均有统计学意义（t=9.49、6.57,均P<0.001）,而T/L的差异无统计学意义（t=2.01,P>0.05）;中低分化HCC的病变SUV_max的差异无统计学意义（t=?1.68,P>0.05）,肝本底SUV_max、T/L间的差异均有统计学意义（t=8.41、?5.43,均P<0.001）;良性病变的SUV_max的差异无统计学意义（t=1.51,P>0.05）。18F-FDG 与其联合11C-CHO PET/CT的SUV_max的 ROC曲线间的差异有统计学意义（Z=2.037,P<0.05）。 结论 18F-FDG PET/CT双时相显像及18F-FDG联合11C-CHO PET/CT多模态显像可分别提高中低及高分化原发性HCC的检出率,对肝癌患者治疗方案的决策及临床预后判定有重要的指导价值。     

18F-FDG PET-CT在非小细胞肺癌骨转移诊断中的应用

目的 探讨非小细胞肺癌(NSCLC)骨转移的的特点及 18F-脱氧葡萄糖正电子发射计算机断层摄影术(18F-FDG PET-CT)对NSCLC骨转移的诊断价值.资料与方法 回顾性分析114例经病理证实的NSCLC患者的临床资料和18F-FDG PET-CT显像结果,并与CT结果进行对比.结果 NSCLC骨转移率为25.44%(29/114),其中腺癌36.21%(21/58),鳞癌14.89%(7/47),混合癌14.29%(1/7),2例大细胞肺癌患者未发生骨转移;共有骨转移病灶103处,骨转移好发部位为肋骨(34.95%)和胸椎(33.98%),其次是骨盆(13.59%)和腰椎(13.59%).18F-FDG PET-CT显像发现101 处病灶,均呈放射性摄取增高,对NSCLC骨转移诊断的敏感性为98.06%;CT发现91处病灶,对NSCLC骨转移诊断的敏感性为88.35%;两者差别有统计学意义.结论 NSCLC中腺癌骨转移率最高,骨转移常见部位是肋骨和胸椎.18F-FDG PET-CT能发现CT所不能发现的早期NSCLC骨转移病灶,对NSCLC骨转移的正确诊断很有意义.     

双时相18F-FDG PET显像用于肿瘤良恶性鉴别诊断

目的探讨双时相^18F-FDG PET显像在肿瘤良恶性鉴别中的临床价值。方法52例单次显像难以鉴别病变性质的患者行双时相全身^18 F-FDG PET／CT显像，将显像结果与病理学检查结果对照。结果43例延迟显像SUV升高的患者中有39例经病理检查证实为恶性病变，4例为良性病变；9例延迟显像SUV降低的患者中有7例经病理检查证实为良性病变，2例为恶性病变。灵敏度为95．1％，准确性为88．5％，特异性为63．6％，阳性预测值为90．7％，阴性预测值为7／9例。结论双时相^18F—FDG PET对良恶性病变的鉴别具有较高的灵敏度和准确性。     

Dual-time-point 18F-FDG PET for the evaluation of gallbladder carcinoma.

Conventional imaging techniques such as ultrasonography, CT, and MRI are able to detect gallbladder abnormalities but are not always able to differentiate a malignancy from other disease processes such as cholecystitis. The purpose of the present study was to evaluate the efficacy of dual-time-point (18)F-FDG PET for differentiating malignant from benign gallbladder disease. METHODS: The study evaluated 32 patients who were suspected of having gallbladder tumors. (18)F-FDG PET (whole body) was performed at 62 +/- 8 min (early) after (18)F-FDG injection and was repeated 146 +/- 14 min (delayed) after injection only in the abdominal region. We evaluated the (18)F-FDG uptake both visually and semiquantitatively. Semiquantitative analysis using the standardized uptake value (SUV) was performed for both early and delayed images (SUV(early) and SUV(delayed), respectively). The retention index (RI) was calculated according to the equation (SUV(delayed) - SUV(early)) x 100/SUV(early). The tumor-to-liver ratio was also calculated. Results: The final diagnosis was gallbladder carcinoma in 23 patients and benign disease in 9 patients. For visual analysis of gallbladder carcinoma, delayed (18)F-FDG PET images improved the specificity of diagnosis in 2 patients. When an SUV(early) of 4.5, SUV(delayed) of 2.9, and RI of -8 were chosen as arbitrary cutoffs for differentiating between malignant and benign conditions, sensitivity increased from 82.6% to 95.7% and 100% for delayed imaging and combined early and delayed imaging (i.e., RI), respectively. With the same criteria, specificity decreased from 55.6% to 44.4% for delayed imaging and combined early and delayed imaging, respectively. The specificity of (18)F-FDG PET improved to 80% in the group with a normal level of C-reactive protein (CRP) and decreased to 0% in the group with an elevated CRP level. For gallbladder carcinoma, both SUV and tumor-to-liver ratios derived from delayed images were significantly higher than the ratios derived from early images (P < 0.0001). CONCLUSION: Delayed (18)F-FDG PET is more helpful than early (18)F-FDG PET for evaluating malignant lesions because of increased lesion uptake and increased lesion-to-background contrast. However, the diagnostic performance of (18)F-FDG PET depends on CRP levels.     

Evaluation of delayed18F-FDG PET in differential diagnosis for malignant soft-tissue tumors

OBJECTIVE: Positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG) has been used for the evaluation of soft-tissue tumors. However, the range of accumulation of 18F-FDG for malignant soft-tissue lesions overlaps with that of benign lesions. The aim of this study is to investigate the usefulness of delayed 18F-FDG PET imaging in the differentiation between malignant and benign soft-tissue tumors. METHODS: Fifty-six patients with soft-tissue tumors underwent whole body 18F-FDG PET scan at 1 hour (early scan) and additional scan at 2 hours after injection (delayed scan). The standardized uptake value (SUV(max)) of the tumor was determined, and the retention index (RI) was defined as the ratio of the increase in SUV(max) between early and delayed scans to the SUV(max) in the early scan. Surgical resection with histopathologic analysis confirmed the diagnosis. RESULTS: Histological examination proved 19 of 56 patients to have malignant soft-tissue tumors and the rest benign ones. In the scans of all 56 patients, there was a statistically significant difference in the SUV(max) between malignant and benign lesions in the early scan (5.50 +/- 5.32 and 3.10 +/- 2.64, respectively, p < 0.05) and in the delayed scan (5.95 +/- 6.40 and 3.23 +/- 3.20, respectively, p < 0.05). The mean RI was not significantly different between malignant and benign soft-tissue tumors (0.94 +/- 23.04 and -2.03 +/- 25.33, respectively). CONCLUSIONS: In the current patient population, no significant difference in the RI was found between malignant and benign soft-tissue lesions. Although the mean SUV(max) in the delayed scan for malignant soft-tissue tumors was significantly higher than that for benign ones, there was a marked overlap. The delayed 18F-FDG PET scan may have limited capability to differentiate malignant soft-tissue tumors from benign ones.     

18F-FDG PET显像在胰腺恶性病变鉴别诊断及转移灶探查中的应用价值

目的研究18F-FDGPET显像在胰腺恶性肿瘤诊断与鉴别诊断中的应用价值。方法 40例临床疑为胰腺恶性病变的患者均行18F-FDGPET显像,对显像结果进行目测法及SUV值半定量分析,并结合CT,MRI等影像学检查进行综合诊断,最后诊断根据手术病理或经4个月以上随访证实。结果如果以SUV为2.5作为鉴别诊断胰腺病灶良恶性的阈值,24例证实为胰腺癌患者中18F-FDGPET显像正确诊断22例,16例胰腺良性病变患者18F-FDGPET检出13例,其灵敏度、特异度及准确性分别为91.7%（22/24）,81.3%（13/16）及87.5%（35/40）;而结合CT,MRI等其他检查结果进行综合诊断,其诊断灵敏度、特异度及准确性分别为91.7%（22/24）、87.5%（14/16）及90%（36/40）。恶性病变的SUV平均值为4.6±2.6,良性病变的SUV平均值为2.3±1.5,良恶性病变间SUV平均值差异有统计学意义（P〈0.01）。在转移灶的检出中,18F-FDGPET显像发现了全部38处转移灶,并发现6处CT,MRI未能发现的远处转移病灶,排除了1例CT认为是胰周转移性淋巴结肿大的病例。结论 18F-FDGPET对鉴别诊断胰腺良恶性肿瘤的灵敏度、特异性较高,尤其在远处转移灶的探查中有较高应用价值。     

18F-FDG accumulation with PET for differentiation between benign and malignant lesions in the thorax.

Recent reports have indicated the value and limitations of (18)F-FDG PET and (201)Tl SPECT for determination of malignancy. We prospectively assessed and compared the usefulness of these scintigraphic examinations as well as (18)F-FDG PET delayed imaging for the evaluation of thoracic abnormalities. METHODS: Eighty patients with thoracic nodular lesions seen on chest CT images were examined using early and delayed (18)F-FDG PET and (201)Tl-SPECT imaging within 1 wk of each study. The results of (18)F-FDG PET and (201)Tl SPECT were evaluated and compared with the histopathologic diagnosis. RESULTS: Fifty of the lesions were histologically confirmed to be malignant, whereas 30 were benign. On (18)F-FDG PET, all malignant lesions showed higher standardized uptake value (SUV) levels at 3 than at 1 h, and benign lesions revealed the opposite results. Correlations were seen between (18)F-FDG PET imaging and the degree of cell differentiation in malignant tumors. No significant difference in accuracy was found between (18)F-FDG PET single-time-point imaging and (201)Tl SPECT for the differentiation of malignant and benign thoracic lesions. However, the retention index (RI) of (18)F-FDG PET (RI-SUV) significantly improved the accuracy of thoracic lesion diagnosis. Furthermore, (18)F-FDG PET delayed imaging measuring RI-SUV metastasis was useful for diagnosing nodal involvement and it improved the specificity of mediastinal staging. CONCLUSION: No significant difference was found between (18)F-FDG PET single-time-point imaging and (201)Tl SPECT for the differentiation of malignant and benign thoracic lesions. The RI calculated by (18)F-FDG PET delayed imaging provided more accurate diagnoses of lung cancer.     

^18F-FDG PET／CT双时相显像对肺部病灶的定性诊断价值

目的探讨^18F-脱氧葡萄糖（FDG）PET／CT双时相显像在肺部病灶良恶性鉴别诊断中的临床应用价值。方法78例临床疑诊肺癌患者,均行早期和延迟^18F—FDG PET／CT显像。计算早期及延迟显像最大标准摄取值（SUVmax）,并计算2次显像SUVmax变化率（ASUV）。以SUVmax〉2．5和ASUV〉20％作为诊断肺癌的标准。患者最终诊断均经组织病理学、细菌学或治疗后随访证实。采用SPSS13．0软件,SUV组间比较用t检验,用受试者工作特征（ROC）曲线评价SUVmax、ASUV对肺部病灶的定性诊断价值。结果（1）78例患者中肺癌60例,良性病变18例（增殖性病变16例,占88．89％）。肺癌组（9．92±5．33和7．94±4．17,t=10．19）和良性病变组（8．54±6．61和7．21±5．74,t=8．23,P均〈0．01）延迟SUVmax均明显高于早期SUVmax;肺癌组与良性病变组间早期和延迟显像SUVmax差异均无统计学意义（t=0．60和-0．91,P均〉0．05）;肺癌组与良性病变组ASUV差异也无统计学意义[（26．04±14．73）％和（18．09±24．09）％,t=1．67,P〉0．05]。18例良性病变患者中有2例延迟显像SUVmax较早期减低,而肺癌患者延迟显像SUVmax均无减低。（2）以SUVmax〉2．5和ASUV〉20％为诊断肺癌的标准,其灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为93．33％（56／60）和63．33％（38／60）、22．22％（4／18）和50．00％（9／18）、76．92％（60／78）和60．26％（47／78）、80．00％（56／70）和80．85％（38／47）、50．00％（4／8）和70．97％（22／31）;根据SUVmax和ASUV得到的ROC曲线下面积分别为0．61（Z=1．38,P〉0．05）和0．56（Z=0．65,P〉0．05）,差异均无统计学意义。结论对肺部病灶临床疑诊为肺癌的患者,如良性病变以增殖性病变为主,则^18F—FDG PET双时相显像良恶性鉴别诊断临床应用价值不大;但延迟SUVmax减低可能?     

18F-FDG PET/CT结合高分辨率CT对孤立性肺结节的诊断价值

目的探讨^18F-脱氧葡萄糖（FDG）PET／CT结合高分辨率CT（HRCT）对孤立性肺结节（SPN）的鉴别诊断价值。方法25例经手术病理检查或治疗随访证实的SPN（共27个）患者，同期行^18F—FDGPET／CT显像和病灶部位HRCT检查。^18F—FDGPET／CT用目测法结合半定量法判断良恶性。HRCT则根据病灶形态学特征判断良恶性。所得^18F—FDGPET／CT结果和^18F—FDGPET／CT与HRCT相结合结果分别与病理检查结果对照比较。结果27个SPN中15个恶性，12个良性。PET／CT正确诊断14个恶性和9个良性SPN。3个良性SPNPET／CT显像为阳性，其中2个经PET／CT和HRCT联合诊断为良性。联合诊断灵敏度和单纯PET／CT相同（93．3％），但特异性、阳性预测值、阴性预测值、准确性分别高于PET／CT（91．7％、93．3％、91．7％和93．7％对75．0％、82．4％、90．0％和85．2％）。结论^18F—FDGPET／CT结合HRCT是有效的无创性鉴别SPN良恶性的方法。