符合线路断层显像对肺部肿块的诊断价值

Value of ^(18)F-FDG SPECT coincidence imaging for the diagnosis of pulmonary mass

目的:探讨以18F-FDG为代谢示踪剂的单光子发射型计算机断层(single photon emission computer tomographic,SPECT)进行符合线路显像(符合线路断层显像)对肺部肿块的诊断价值。方法:106例患者全部取得病理诊断,恶性肿瘤84例,良性肿块22例。将患者的胸部符合线路断层显像和CT的检查结论与病理结果进行比较。结果:符合线路断层显像诊断恶性肿瘤90例,良性肿块16例,其中假阳性9例,假阴性3例;胸部CT诊断恶性肿瘤86例,良性肿块20例,其中假阳性13例,假阴性11例。统计分析显示,对于诊断的敏感性、准确率和阴性预测值,二者间的差异有显著性,前者优于后者。结核是引起假阳性的主要病种,符合线路断层显像误判的9例中,6例为结核。引起误判的结核的病理形态通常表现为以增生为主的结节样病灶。结论:符合线路断层显像对肺部肿块的定性诊断具有较高的实用价值,对治疗方案的制订有指导意义。

Objective： To study the value of 18F fluorodeoxyglucose （FDG） coincidence imaging for the diagnosis of pulmonary mass. Method：To compare the conclusions of 18F-FDG SPECT coincidence imaging and CT, with the pathological diagnosis as a gold standard. Totally 106 patients were included. Among them, 22 cases were pathologically benign, and 84 cases were malignant. Result： With ^18s F-FDG SPECT coincidence imaging, 90 cases were diagnosed as cancer and 16 cases as benign lesions. With comparison of the pathological results, the falsepositive cases were 9, and the false-negative cases were 3. With CT, 86 cases were diagnosed as cancer, and 20 cases as benign lesions. Among which, the false-positive cases were 13, and the false-negative cases were 3. ^18F- FDG SPECT coincidence imaging is statistically superior to CT in aspects of the sensitivity, accuracy and negative predictive value. Tuberculosis is the main disease that brings false-positive conclusion. Specifically, tubercular hyporplasia is the predominant pathological type that leads to misdiagnosis among all the tuberculosis patients. Conclusion：The ^18 F-FDG SPECT coincidence imaging has a very high value for the diagnosis of pulmonary mass, and also for making treatment scheme.