^(18)F-PET/CT在肺磨玻璃结节诊断中的应用

Clinical value of ^(18)F-PET/CT for diagnosis of pulmonary ground-glass opacity nodules

目的探讨肺恶性磨玻璃结节(ground-glass opacity,GGO)的18 F-FDG PET/CT影像学特点及18 F-FDG PET/CT鉴别肺GGO良恶性的诊断价值。方法对82例行PET/CT检查的肺GGO患者的临床资料及PET/CT影像学特点行回顾分析,其中51例患者均经手术病理确诊,31例随访疗效后明确诊断。结果 82例患者中,50例为恶性病变,32例为良性病变。单因素分析显示,PET/CT下GGO的密度类型、分叶、边界、毛刺、胸膜凹陷征、充气空泡征以及标准摄取值(standardized up take value,SUV)平均值、最大值对于良恶性鉴别有意义。多因素分析显示,混合型GGO、边界不清GGO及分叶GGO是恶性GGO的预测因子。ROC曲线分析结果显示SUV最大值与平均值对于GGO的良恶性鉴别准确性较低(AUC=0.679、0.682)。结论18F-PET/CT对恶性GGO的诊断有良好的敏感性和特异性。

Objective To evaluate the application of18F-FDG PET / CT imaging in diagnosis and differential diagnosis of lung ground-glass opacity（ GGO） nodules. Methods The clinical data and PET / CT images of 82 patients with lung ground-glass opacity nodules were retrospectively reviewed.Among 82 cases the diagnosis was confirmed by operation and pathology in 51 cases and confirmed during follow-up in 31 cases. Results Among 82 patients,50 cases were malignant and 32 were benign. Univariate analysis showed that there were significant differences in density type,divided leaves on GGO PET / CT,boundary,burr,pleural indentation,inflatable vacuole sign,the average SUV values of SUV,SUV maximum between benign and malignant lesions. M ultivariate analysis showed that mixed GGO,unclear boundary and leaf GGO was a predictor of malignancy. ROC curve showed that the accuracy of maximum SUV value and average value was lowin differentiating benign and malignant GGO nodules（ AUC = 0. 679,0. 682）. Conclusion18F-PET / CT is highly sensitive and specific in diagnosis of malignant lung ground-glass nodules.