18F-FDG SPECT符合线路显像对颈部淋巴结转移癌的诊断及预测价值

目的 探讨18F-FDG SPECT符合线路显像对诊断颈部淋巴结转移癌的预测价值。 方法 收集2015年11月-2016年5月浙江衢化医院就诊的46例疑似颈部淋巴结转移癌患者临床病理资料,所有入组患者分别行18F-FDG SPECT符合线路显像和常规影像学的检查,入组患者均取得病理结果,比较不同检查方法在颈部淋巴结转移癌诊断中的灵敏度、特异度、准确率、阳性预测值及阴性预测值;测定入组患者病灶与正常组织的放射线基线比值(T/N比值),采用独立样本t检验分析淋巴结转移癌患者18F-FDG SPECT符合线路显像的显像特点,比较不同检查方法在其他转移灶诊断中的价值。 结果 18F-FDG SPECT符合线路显像和常规影像学检查对颈部淋巴结转移癌患者的原发灶诊断灵敏度、特异度、准确率、阳性预测值及阴性预测值分别为87.5%、83.3%、87.0%、97.2%、50.0%和70.0%、33.3%、65.2%、87.5%、14.3%;淋巴结转移癌患者病灶T/N平均值为7.15±3.51,非淋巴结转移癌患者病灶T/N平均值为4.26±2.37,明显低于淋巴结转移癌患者,差异有统计学意义(P<0.05);18F-FDG SPECT符合线路显像共检出转移淋巴结和其他转移灶平均数分别为10.24±3.47和1.58±1.64,常规影像学检查检出平均数分别为6.18±4.38和0.62±0.48,明显低于18F-FDG SPECT符合线路显像,差异均有统计学意义(P<0.05)。 结论 18F-FDG SPECT符合线路显像对颈部淋巴结转移癌诊断及预测价值更高,同时还可更高效的发现其他转移灶。 

Diagnostic and predictive value of 18F-FDG SPECT imaging for cervical lymph node metastasis cancer

Objective To investigate the predictive value of 18F-FDG SPECT imaging for the diagnosis of cervical lymph node metastasis cancer. Methods The clinical and pathological data of 46 suspected cervical lymph node metastasis cancer in our hospital from November,2015 to May,2016 were collected.All the patients underwent 18F-FDG SPECT scan and conventional imaging,and were all achieved pathological results.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of different screening method in the diagnosis of cervical lymph node metastasis cancer were compared.The maximum standardized uptake value (T/N) of focus in patients enrolled was measured and the 18F-FDG SPECT imaging characteristics of lymph node metastasis cancer were analyzed;The diagnostic value of different methods to check other metastasis focus were compared. Results The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 18F-FDG SPECT and conventional imaging for the primary lesion of cervical lymph node metastasis cancer were 87.5%,83.3%,87.0%,97.2%,50% and 70.0%,33.3%,65.2%,87.5%,14.28%,respectively;The average T/N of focus in patients with lymph node metastasis cancer was 7.15±3.51,while it in patients with non-metastatic lymph nodes cancer was 4.26±2.37,significantly lower than it in the lymph node metastasis cancer patients,the differences were statistically significant (P<0.05);The number of the lymph node and other metastatic focus detected by 18F-FDG SPECT were 10.24±3.47 and 1.58±1.64,while they detected by the conventional imaging were 6.18±4.38 and 0.62±0.48,significantly lower than the 18F-FDG SPECT,the differences were statistically significant (P<0.05). Conclusion 18F-FDG SPECT imaging have a higher diagnostic and predictive value for the cervical lymph node metastasis cancer,and can also find other metastases more efficiently.