^18F-FDGPET/CT对不明原因发热（FUO）疑难病例病因诊断的效果分析

Effect of （18）~F-FDG PET/CT on Etiological Diagnosis for Fever of Unknown Origin（FUO）

[目的]回顾分析18F-FDG PET/CT(FDG-PET)对FUO疑难病例病因的诊断价值。[方法]67例FUO患者行FDG-PET检查,病理及随访结果确定病因。[结果 ]FDG-PET对FUO病因诊断的总有效率为40.3%,对肿瘤(90.0%)诊断能力最强,其次为感染(33.3%)和免疫疾病(20.0%)。肿瘤患者脾大发生率明显增高,淋巴结大和脏器(淋巴结、脾和骨髓)代谢增高发生率以及增高程度与感染和免疫疾病组间无差异。FDG-PET有效组患者淋巴结和脾代谢以及血ESR增高程度与无效组有明显差异。[结论]FDG-PET对FUO疑难病例病因诊断有效率低;肿瘤、感染及免疫系统疾病FDG-PET影像表现有重叠;脾大、淋巴结和脾代谢及血ESR增高程度有助于FUO病因诊断。

[Purpose] To investigate the value of 18F-FDG PET/CT（FDG-PET） on etiological diagnosis of FUO.[Methods] A total of 67 patients underwent routine FDG-PET scan.Etiologies of FUO were determined by either pathological or follow-up results.[Results] The total effective rate of FDG-PET in finding causes of FUO was 40.3%.The diagnostic efficacy rate for malignancies was 90.0%,then the infections（33.3%） and immunological diseases（20.0%）.Except enlarged splenomegaly in malignancies,the incidences of enlarged lymph node and the hypermetabolism in lymph node,spleen and bone marrow showed no difference among malignancies,infections and immunological diseases.Twenty seven patients benefiting from FDG-PET exhibited lower elevated level of ESR and higher hypermetabolism in spleen than those achieved nothing from FDG-PET.[Conclusions] FDG-PET shows inferiority in identification of the etiology of FUO.The characteristics of FDG-PET images are overlap among malignant,infections and immunological diseases.The radioactivity of lymph node and spleen as well as the level of ESR are helpful for diagnosis of FUO.