^(18)F-FDG符合线路胸部显像假阴性原因分析

Analysis of false negative of ^(18)F-FDG coincidence imaging for chest

目的对86例18F-FDG符合线路显像为假阴性的患者进行回顾性调查,探讨影响病灶显像的因素,为临床提供帮助。方法将假阴性组的性别、年龄、给药剂量、体质量、血糖水平、病灶大小、病变性质、病理分型、病变活动性以及细胞分化程度与阳性组进行对比分析,并对数据做统计学处理。结果假阴性组的性别(2=1.636,P=0.201)、平均年龄(t=1.437,P=0.151)、给药剂量(t=0.925,P=0.356)与阳性组间的差异不具有统计学意义,而体质量(t=2.372,P=0.018)、血糖(t=1.988,P=0.047)、病灶大小(t=2.900,P=0.004)、病变性质(2=13.145,P=0.000)、病理分型(2=4.894,P=0.027)、病变的活动性(2=21.660,P=0.000;2=4.093,P=0.043)以及细胞分化程度(2=8.320,0.996;4.552,P=0.004,0.000,0.033.)与阳性组存在有统计学意义的差异。结论病灶显像与否与患者的年龄、性别与给药的绝对剂量无关,与患者的体质量、给药的相对剂量、病灶的大小和病变的性质有关,过大的体质量或相对小的给药剂量、过高的血糖、过小的病灶、多数良性肿瘤、大多数高分化及部分中分化(尤其是小于2.5cm)恶性肿瘤,尤其是放化疗后6周以后的恶性病变以及大部分支气管肺泡癌、非活动性病变和少数轻度感染性病变(尤其病变小于2.5cm)容易造成假阴性结果。

Objective To retrospectively investigate for 18F-FDG coincidence imaging in 86 false-negative patients to identify factors that affect lesion imaging, which could offer right help and assistance while analysis for image results. Methods We analyzed the false-negative in terms of gender, age, medication dose, body weight, blood glucose levels, tumor size, nature of lesions, pathological type, disease activity and cell differentiation, compared the data with the positive group, find out the differences between the two groups, and then did statistical analysis for all data input. Results There were no statistically significant for false-negative group in category of gender （X2 = 1. 636, P =0. 201）, average age （ t =1. 437, P =0. 151）, medication dose （ t =0. 925, P=0. 356） while comparing with positive group. And statistically significant were found comparing false-negative and positive in category of body mass （ t = 2. 372, P = 0. 018）, level of blood glucose （ t =1. 988, P =0. 047）, tumor size （ t =2. 900, P =0. 004）, nature of lesions （χ2 =13. 145, P =0. 000）, pathological type （χ2 =4. 894, P =0. 027）, disease activity （χ2 =21. 660, P =0. 000; χ2 =4. 093, P =0. 043）, and cell differentiation （χ2 = 8. 320,0. 996 ; 4. 552, P = 0. 004, 0. 000, 0. 033）. Conclusion Imaging of lesions has no relation with age, gender and administration of absolute dose, but there is related with patient＇s body mass, administration of the relative dose, lesion size, and the nature of disease. Excessive body weight or relative small dose administration, high blood sugar, too small lesions, the majority of benign tumors, the most well-differentiated （especially less than 2.5 cm） malignant tumors especially after 6 weeks after radiotherapy and chemotherapy and most bronchioloalveolar carcinoma, non-active disease, and a few mild infectious disease （especially lesions less than 2.5 cm） easily lead to false negative results.