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18F-FDG PET/CT联合同机HRCT对肺磨玻璃结节的诊断价值
引用本文:张辉,唐嘉励,段东.18F-FDG PET/CT联合同机HRCT对肺磨玻璃结节的诊断价值[J].国际放射医学核医学杂志,2017,41(4):241-246.
作者姓名:张辉  唐嘉励  段东
作者单位:400016, 重庆医科大学附属第一医院核医学科
基金项目:国家临床重点专科建设项目,重庆市科技计划项目(渝科发计[2014]21号).National Key Clinical Specialties Construction Program of China,Chongqing Science and Technology Plan Program
摘    要:目的探讨18F-FDG PET/CT联合同机高分辨率CT(HRCT)对肺磨玻璃结节的诊断价值。方法回顾性分析经手术病理或临床随访证实的72例肺磨玻璃结节患者(恶性40例、良性32例)资料,对其临床资料、影像特征、SUVmax等参数进行统计学分析。结果单因素分析结果显示,HRCT下肺磨玻璃结节的直径(t=4.932,P < 0.001)、密度(χ2=29.425,P < 0.001)、分叶征(χ2=9.626,P=0.002)、毛刺征(χ2=7.605,P=0.006)、胸膜凹陷征(χ2=4.585,P=0.032)、血管集束征(χ2=7.605,P=0.006)及SUVmax(t=3.884,P < 0.001)在良、恶性两组间差异均有统计学意义。而性别(χ2=0.026,P=0.873)、年龄(t=1.417,P=0.161)、空泡征(χ2=3.214,P=0.073)及空气支气管征(χ2=1.664,P=0.197)在两组间差异均无统计学意义。多因素分析结果显示,混合型密度是鉴别良恶性病变的显著预测因子(χ2=10.261,OR=23.515,P < 0.05)。受试者工作特征曲线分析结果显示,以结节直径≥11 mm、SUVmax≥0.9为评判指标具有较好的鉴别精度。HRCT、PET/CT及PET/CT联合HRCT对肺磨玻璃结节诊断的灵敏度分别为75.0%、82.5%、90.0%,特异度分别为81.3%、78.1%、68.8%,准确率分别为77.8%、80.6%、80.6%。结论18F-FDG PET/CT联合HRCT通过对肺磨玻璃结节的代谢情况及影像学分析,对其鉴别诊断有一定的临床价值,两者联合使用可以提高诊断的灵敏度。

关 键 词:氟脱氧葡萄糖F18    正电子发射断层显像术    高分辨率CT    磨玻璃结节    标准化摄取值
收稿时间:2017-03-07

Value of 18F-FDG PET/CT combined with the same scanner HRCT in the diagnosis of pulmonary ground-glass nodules
Zhang Hui,Tang Jiali,Duan Dong.Value of 18F-FDG PET/CT combined with the same scanner HRCT in the diagnosis of pulmonary ground-glass nodules[J].International Journal of Radiation Medicine and Nuclear Medicine,2017,41(4):241-246.
Authors:Zhang Hui  Tang Jiali  Duan Dong
Institution:Department of Nuclear Medicine, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
Abstract:Objective To investigate the value of 18F-FDG PET/CT combined with the same scanner high resolution CT (HRCT) in the diagnosis of pulmonary ground-glass nodules (GGNs).Methods A total of 72 patients with pulmonary GGNs (40 cases were malignant,32 presented benign lesions) were retrospectively analyzed and confirmed by surgical pathology or clinical follow-up.The clinical data,imaging features,maximum standardized uptake value (SUVmax)were analyzed statistically.Results Univariate analysis showed significant differences in diameter (t=4.932,P<0.001),density type (x2 =29.425,P<0.001),lobular sign (x2=9.626,P=0.002),spiculation sign (x2 =7.605,P=0.006),pleural indentation (x2=4.585,P=0.032),vascular convergence (x2=7.605,P=0.006),and SUVmax(t=3.884,P< 0.001).By contrast,no differences in gender (x2 =0.026,P=-0.873),age (t=1.417,P=0.161),vacuole sign (x2=3.214,P=0.073),and air bronchus sign (x2=1.664,P=0.197)were observed between the two groups in HRCT.Multivariate analysis showed that mixed density was a notable predictor of malignancy (x2=10.261,OR=23.515,P<0.05).The receiver operating characteristic curve showed the diameter ≥11 mm and SUVnax ≥ 0.9 as the standard reference indexes that yielded good identification accuracy.The sensitivity of HRCT,PET/CT,and PET/CT combined with the same scanner HRCT in the diagnosis of GGNs were 75.0%,82.5%,and 90.0%,with specificity values of 81.3%,78.1%,and 68.8% and accuracy of 77.8%,80.6%,and 80.6%,respectively.Conclusions 18F-FDG PET/CT combined with the same scanner HRCT present certain clinical value in the differential diagnosis of GGNs by analyzing the metabolic condition and imaging characteristics.This approach can improve diagnostic sensitivity.
Keywords:Fluorodeoxyglucose F18  Positron-emission tomography  High resolution CT  Ground-glass nodule  Standardized uptake value
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