PET-CT 双时相显像对SPN 的诊断价值评价

Evaluation of value of PET-CT dual phase imaging in diagnosis of SPN

摘要:

目的 评价PET-CT 双时相显像对孤立性肺结节（SPN）的诊断价值。方法 选取2014 年7 月- 2015 年12 月青海省人民医院PET-CT 中心就诊的SPN 患者152 例，进行18F-FDG PET-CT 检查并且手术后 病理确诊其结节的良恶性。比较良恶性结节患者的早期SUVmax 值、延迟期SUVmax 值、代谢滞留指数的差异和 各肿瘤症像显示率的差异。SUVmax 值鉴别诊断SPN 良恶性的ROC 曲线分析。结果 152 例SPN 患者术后经 组织病理学证实恶性结节92 例和良性结节60 例，恶性结节早期SUVmax 值（7.86±3.15）、延迟期SUVmax 值 （9.03±3.49）、代谢滞留指数（20.59±12.87）均高于良性结节SUVmax 值（3.36±2.88）、延迟期SUVmax 值（3.12± 2.64）、代谢滞留指数（10.46±3.59）（P <0.05）；恶性结节的分叶征、毛刺征、血管集束征、空泡征的显示率高 于良性结节（P <0.05）；早期SUVmax 值的ROC 曲线下面积为70.07（95%CI ：57.95，82.19），敏感性和特异 性分别为52.17% 和96.67% ；延迟期SUVmax 值的ROC 曲线下面积为93.19（95%CI ：87.69，98.68），敏感性和特 异性分别为93.48% 和83.33% ；代谢滞留指数的ROC 曲线下面积为87.90（95%CI ：80.20，95.59），敏感性和特 异性分别为82.61% 和80.0%。结论 PET-CT 双时相显像对SPN 良恶性的鉴别诊断具有重要的临床价值。

Abstract:

Objective To evaluate the value of PET-CT dual phase imaging in the diagnosis of solitary pulmonary nodules (SPN). Methods A total of 152 cases of SPN in our hospital from July 2014 to December 2015 were selected. All of them were performed with 18F-FDG PET-CT examination. And the benign and malignant nodules were confirmed by pathological diagnosis after surgery. The differences of the early SUVmax value, the delay period SUVmax value, metabolic retention index and the display rate of tumor image were compared between the patients with benign and malignant nodules. ROC curve of SUVmax value for differential diagnosis of benign and malignant SPN was analyzed. Results In the 152 patients with SPN, 92 cases of malignant nodule and 60 cases of benign nodules were confirmed by histopathology after operation. The early SUVmax value (7.86 ± 3.15), the delay period SUVmax value (9.03 ± 3.49) and the metabolic retention index (20.59 ± 12.87) of the malignant nodules were higher than those of the benign nodules [(3.36 ± 2.88), (3.12 ± 2.64) and (10.46 ± 3.59) respectively], and the differences had statistical significance (P < 0.05). The display rate of lobulation sign, spiculation sign, vessel convergence sign and vacuole sign in the malignant nodules was higher than that of the benign nodules, and the difference was statistically significant (P < 0.05). The area under ROC curve of the early SUVmax value was 70.07 (57.95-82.19), the sensitivity and specificity were 52.17% and 96.67% respectively. The area under ROC curve of the delay period SUVmax value was 93.19 (87.69-98.68), the sensitivity and specificity were 93.48% and 83.33% respectively. The area under ROC curve of the metabolic retention index was 87.90 (80.20-95.59), and the sensitivity and specificity were 82.61% and 80.00% respectively. Conclusions PET-CT dual phase imaging has important clinical value in the differential diagnosis of benign and malignant pulmonary solitary nodules.