结核性与肿瘤性腹膜弥漫性病变的18F-FDG PET/CT影像特征比较

目的 探讨结核性与肿瘤性腹膜弥漫性病变的18 F-FDG PET/CT相关影像表现.方法 对结核性与肿瘤性腹膜弥漫性病变的相关18F-FDG PET/CT影像表现进行量化分级,采用x2检验、两样本独立t检验、Logistic回归及ROC曲线进行统计学分析.结果 单因素分析结果显示,腹膜SUVmax、腹水CT值、壁腹膜增厚情况、网膜增厚情况及其他脏器受累情况在结核性与肿瘤性腹膜弥漫性病变中差异有统计学意义(P＜0.05);多因素分析显示,网膜增厚情况及其他脏器受累情况在结核性与肿瘤性腹膜弥漫性病变中差异有统计学意义(P＜0.05),二元Logistic回归方程为Y=1.201+1.517X3+1.980X9,X3及X9的OR 值分别为4.559(95％ CI:0.707～ 29.391)及7.242(95％ CI:1.726～30.385);ROC曲线显示网膜增厚情况、其他脏器受累情况对结核性及肿瘤性病变的鉴别有效,两者的AUC分别是0.670(95％ CI:0.527～0.813)和0.655(95％ CI:0.525 ～0.785),前者的诊断效能较高(P＜0.05).结论 分析结核性与肿瘤性腹膜弥漫性病变的18F-FDG PET/CT影像表现,可提高两者的鉴别诊断水平.

Features of 18F-FDG PET/CT imaging in differential diagnosis of tuberculous and cancerous diffuse peritoneal lesions

Objective To analyze the difference of 18F-FDG PET/CT imaging features between tuberculous and cancerous diffuse peritoneal lesions.Methods Quantitative classification of 18 F-FDG PET/CT imaging features of tuberculous and cancerous diffuse peritoneal lesions was conducted.Statistical methods,such as analysis of variance,chi-square test,two independent sample t-test and cumulative logistic model were applied to analysis of the data.Results Single factor statistical analysis showed that there was statistically significant difference (P ＜ 0.05) in the involvement of peritoneal SUVmax,ascites CT value,thickening of parietal peritoneum and omentum,and other organs in tuberculous and cancerous diffuse peritoneal lesions.Multivariable statistical analysis showed that there was statistically significant difference (P ＜ 0.05) in the involvement of omentum thickening and other organs in tuberculous and cancerous diffuse peritoneal lesions.The binary logistic regression analysis equation was Y =1.201 + 1.517X3 + 1.980X9,and the odds ratio of X3 and X9 was 4.559 (95 ％ CI:0.707-29.391) and 7.242 (95％ CI:1.726-30.385),respectively.The ROC curve showed that the degree of involvement of omentum thickening and other organs could help identify tuberculous and tumor lesions effectively.The AUC (area under curve) of omentum thickening was 0.670 (95％ CI:0.527-0.813),which was better than that of other organs involved (0.655,95％ CI:0.525-0.785).Conclusion The level of differential diagnosis can benefit from careful analysis of 18 F-FDG PET/CT imaging features of tuberculous and cancerous diffuse peritoneal lesions.