符合线路单光子发射型计算机断层双时相显像鉴别病变性质的临床应用价值

目的:探讨氟[18F]-氟代脱氧葡萄糖(18F-FDG)双探头符合线路单光子发射型计算机断层(SPECT)双时相显像鉴别病变性质的临床应用价值.方法:30例病变性质不明的患者进行18F-FDG符合线路SPECT双时相显像,早期显像在注射18FDG后1 h进行,延迟显像分为2组,一组时间间隔为3.5 h,另一组时间间隔为4.5 h.结果:30例患者(1例患者行2次双时相显像)共检出48个病灶,其中恶性病变30个,良性病变18个,均经病理活检证实或临床随访确诊.用定性法分析,双时相显像的灵敏度96.7%,特异性83.3%,准确率91.7%,阳性预测值90.6%,阴性预测值93.8%.符合线路SPECT早期显像和CT检查的灵敏度、特异性、准确率、阳性预测值、阴性预测值分别为93.3%,72.2%,85.4%,84.8%,86.7%与76.9%,57.1%,70.0%,76.9%,57.1%.所有恶性病变(除1例假阴性病变外)延迟显像T/NT均明显升高(t=-3.071,P＜0.01),而良性病变延迟显像与早期显像T/NT差异无统计学意义(t=0.398,P=0.695).结论:18F-FDG符合线路SPECT双时相显像有利于良、恶性病变鉴别,并有助于提高病变诊断的特异性及准确率.

Study of clinical value of dual-phase imaging using single photon emission computed tomography with coincidence detection for differentiating benign from malignant lesions

Objective: To investigate the clinical value of dual-phase imaging of 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) using single photon emission computed tomography with coincidence detection (SPECT with coincidence) for differentiating benign and malignant lesions. Methods: Thirty patients with unknown lesions from June 2003 to March 2004 in our hospital were enrolled in this study. All patients underwent dual-phase imaging of 18 F-FDG SPECT with coincidence. The early images were obtained 60 min post injection. And the patients were divided into 2 groups, one receiving delayed scans at 210 min after 18 F-FDG injection and the other at 270 min. Lesion status was determined by pathologic findings or by clinical follow-up. Results: Forty-eight lesions (30 malignant and 18 benign lesions verified by pathologic findings or clinical follow-up) of 30 patients were detected by dual-phase imaging, in which there were 29 true positive results, 15 true negative, 3 false positive and 1 false negative. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of dual-phase imaging were 96.7%, 83.3%, 91.6%, 90.6%, and 93.8%, respectively. Those of early imaging and CT were 93.3%, 72.2%, 85.4%, 84.8%, 86.7% and 76.9%, 57.1%, 70.0%, 76.9%, 57.1%, respectively. The T/NT of all malignant lesions(except 1 false negative case) in delayed imaging were significantly increased (t=-3.071,P<0.01). However, there were no statistical differences in the T/NT of benign lesions (t=0.398,P=0.695) between early and delayed imagings. Conclusion: Dual-phase imaging of FDG SPECT with coincidence provides benefit for differentiating benign and malignant lesions.