^(18)F-FDG代谢显像联合CT检查在孤立性肺结节诊断中的临床价值

Clinical value of combined ^(18)F-FDG with CT imaging findings in differential diagnosis of solitary pulmonary nodule

目的:探讨18F-FDG代谢显像联合CT在直径>1.0 cm的孤立性肺结节诊断中的价值。方法:取得病理结果的肺部占位60例患者,肺癌24例,良性肿瘤及其他病变36例,病灶直径>1.0 cm。所有患者均行18F-FDG代谢显像和胸部CT,18FFDG代谢显像根据显像特征、半定量法判断良恶性,CT根据病灶形态学特征判断良恶性,以病理结果为标准,统计单独18FFDG代谢显像、单独CT检查及18F-FDG代谢显像联合CT检查结果,计算诊断肺癌的灵敏度、特异度、准确率、阳性预测值和阴性预测值,行χ2检验。结果:单独18F-FDG代谢显像诊断SPN的良恶性的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为62.5%、86.1%、76.7%、75.0%和77.5%;CT检查方法检测的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为62.5%、72.2%、68.3%、60.0%和74.3%;联合试验(并联试验)灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为87.5%、69.4%、76.7%、65.6%和89.3%。联合检查的灵敏度高于单独18F-FDG或CT检查(P<0.05)。结论:18F-FDG代谢显像联合CT检查在鉴别诊断直径>1.0cm的肺部占位方面灵敏度优于单独CT或18F-FDG代谢显像,18F-FDG代谢显像是对传统CT检查的有效补充。

Objective： To evaluate the value of ^18F-fluorodeoxyglucose（ ^18F-FDG） metabolic imaging combined with CT scans in differential diagnosis of solitary pulmonary nodules over 1.0 cm.Methods：Sixty cases with pulmonary nodules over 1.0 cm were included,among whom 24 were pathologically confirmed as pulmonary cancer and 36 benign tumor or other lesions.All patients underwent ^18F-FDG metabolic imaging and chest CT scans,and estimated for the tumor nature on imaging property ,semiquantitative analysis and focal morphology basis .The diagnostic outcomes were compared between pathologi-cal findings and single ^18F-FDG imaging or combined use of it with CT scans by summing up the sensitivity,specificity,accuracy,positive and negative pre-dictive value of the aforementioned techniques.The results were verified withχ^2 test.Results：By single ^18F-FDG metabolic imaging and CT scans,the sen-sitivity,specificity,accuracy,positive and negative predictive value were 62.5%,86.1%,76.7%,75.0% and 77.5% for the former and 62.5%, 72.2%,68.3%,60.0% and 74.3% for the latter.Combined use of the two techniques led to the sensitivity ,specificity,accuracy,positive and negative predictive value of 87.5%,69.4%,76.7%,65.6% and 89.3%,in which the sensitivity was higher than that of single 18 F-FDG and CT scanning（ P〈0.05）.Conclusion：Combined use of 18F-FDG metabolic imaging with CT scans can be superior in sensitivity to single technique in differentiating diagno-sis of pulmonary nodules over 1.0 cm,suggesting that ^18F-FDG metabolic imaging may be an effective complement to conventional CT scanning .