^99mTc-MIBI-SPECT与定位CT融合显像诊断孤立性肺结节的价值

目的：探讨99mTc-MIBI SPECT与CT融合显像对孤立性肺结节（SPN）的鉴别诊断价值．方法对39例SPN患者行99mTc-MIBI-SPECT与定位CT融合显像，对显像结果进行定性及半定量分析，并根据最终诊断结果，判定该显像方法对 SPN的鉴别诊断价值．结果39例 SPN患者中13例为恶性SPN，26例良性 SPN．99mTc-MIBI-SPECT与定位CT融合显像定性分析对SPN良恶性鉴别诊断灵敏度92.31%（12/13），特异性88.46%（23/26），准确性89.74%（35/39），阳性预测值80%（12/15），阴性预测值95.83%（23/24）．受试者工作特征（ROC）曲线分析显示：以99mTc-MIBI早期摄取比值（EUR）≥1.474为鉴别SPN良恶性界值，灵敏度100%，特异性76.90%；以99mTc-MIBI延迟摄取比值（DUR）≥1.38为鉴别 SPN 良恶性界值，灵敏度100%，特异性76.90%．结论99mTc-MIBI-SPECT与定位CT融合显像对SPN的鉴别诊断有较高的临床价值．

Diagnosis Value of ^99m Tc-MIBI-SPECT and CT Fusion Imaging in Solitary Pulmonary Nodules

Objective To investigate the diagnosis of value 99mTc-MIBI SPECT and CT fusion imaging in the differential solitary pulmonary nodule （ SPN）. Methods Thirty-nine patients with SPN underwent 99mTc-MIBI-SPECT and positioning CT fusion imaging, and the imaging results carried on the qualitative and semi-quantitative analysis. The diagnostic value of the imaging method for SPN was judged according to the results of the final diagnosis. Results Of 39 cases with SPN, 13 cases were malignant and 26 cases were benign. The diagnostic sensitivity, specificity, accuracy, negative predictive value and positive predictive value of 99mTc-MIBI-SPECT positioning CT fusion imaging qualitative analysis in benign and malignant SPN was 92.31%（12/13）,88.46%（23/26）,89.74%（35/39）,80% （12/15） and 95.83% （23/24）,respectively. Receiver operating characteristic （ROC） curve analysis showed：using 99mTc-MIBI early uptake ratio （EUR） ≥1.474 as the critical value for identification the benign and malignant SPN, the sensitivity and specificity was 100% and 76.90%, respectively;using 99mTc-MIBI delayed uptake ratio （DUR） ≥ 1.38 as the critical value, the sensitivity and specificity was 100%and 76.90%. Conclusion The method of 99mTc-MIBI-SPECT and positioning＆amp;nbsp;CT fusion imaging has a high clinical value in the differential diagnosis of SPN.