PET/CT融合三维图像定位肺穿刺活检靶点的增益价值

目的:探讨PET/CT融合三维图像定位肺穿刺活检靶点的增益价值。方法:分析54例PET/CT引导和93例单纯CT引导的范围≥3cm或疑似合并坏死、阻塞性炎症、实变及不张的肺部病变活检资料,比较2种引导方法总的检出率、假阴性率、阴性预测值、准确率,采用配对四格表资料的χ~2检验,进行统计学分析。结果:PET/CT引导组的检出率为98.1%(53/54),假阴性率为5.3%(2/38),阴性预测值为88.2%(15/17),准确率为96.2%(51/53)。单纯CT引导组的检出率为84.9%(79/93),假阴性率为23.3%(10/43),阴性预测值为78.3%(36/46),准确率为87.3%(69/79)。采用配对四格表资料的χ~2检验,2种引导方法的检出率的差异(χ~2=6.50,0.010.05)和准确率的差异(χ~2=2.05,P>0.05)无统计学意义。结论:对于范围≥3cm或疑似合并坏死、阻塞性炎症、实变及不张的肺部病变,PET/CT融合三维图像引导穿刺活检的有效率高于单纯CT形态学引导,有一定的临床增益价值。

Gain Value of Three-dimensional Image with PET/CT Fusion in Localization of Lung Biopsy Target

Purpose: To investigate the gain value of three-dimensional image with PET/CT fusion in localization of lung biopsy target. Methods:Fifty-four cases of PET/CT guided and 93 cases of simple CT-guided biopsy of lung lesions with a range ≥ 3 cm or with suspected necrosis, obstructive inflammation, consolidation and atelectasis were analyzed.The total detection rate, false negative rate, negative predictive value and accuracy of the two guided methods were compared. The χ^2 test was used for statistical analysis. Results:The detection rate of PET/CT guided group was 98.1%(53/54), the false negative rate was 5.3%(2/38), the negative predictive value was 88.2%(15/17), and the accuracy rate was 96.2%.(51/53). The detection rate of the CT-guided group was 84.9%(79/93), the false negative rate was 23.3%(10/43), the negative predictive value was 78.3%(36/46), and the accuracy was 87.3%(69/79). The difference of the detection rate between the two guiding methods(χ^2=6.50, 0.010.05) and the difference of accuracy(χ^2=2.05, P>0.05) were with no statistical significance. Conclusion:For lung lesions with a range ≥ 3 cm or with suspected necrosis, obstructive inflammation, consolidation and atelectasis, the three-dimensional image with PET/CT fusion guided biopsy is more effective than CT morphologic guidance and has a certain clinical value.