| 18F-FDG PET/CT联合同机HRCT对肺磨玻璃结节的诊断价值 |
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| 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. DOI: 10.3760/cma.j.issn.1673-4114.2017.04.002 |
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| 作者姓名： | 张辉 唐嘉励 段东 |
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| 作者单位： | 400016, 重庆医科大学附属第一医院核医学科 |
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| 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 |
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| 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。
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| 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 |
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| 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. DOI: 10.3760/cma.j.issn.1673-4114.2017.04.002 |
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| Authors: | Zhang Hui Tang Jiali Duan Dong |
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| Affiliation: | Department of Nuclear Medicine, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China |
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| 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. |
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| Keywords: | Fluorodeoxyglucose F18 Positron-emission tomography High resolution CT Ground-glass nodule Standardized uptake value |
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