探讨PET/MR/CT多模式融合显像在原因不明发热中寻找致热源的价值

Value of PET/MR/CT Multimodality Combination Imaging in Finding Pyrogens of Fever of Unknown Origin

目的探讨18F-FDG PET/MR/CT多模式融合显像在原因不明发热(fever of unknown origin,FUO)中的诊断价值。方法对在2009—2014年符合FUO诊断标准的57例病例,全部行PET/MR或PET/CT检查后通过手术探查或穿刺活检获得病理诊断,临床诊断而非手术治疗者随访半年以上,通过目测法和半定量分析方法对18F-FDG PET/MR/CT的诊断结果进行评价。结果 57例FUO患者,其中能明确致热源的有43例,包括感染性炎性反应16例,恶性肿瘤12例,非感染性炎性反应8例,其他类型7例,未能发现病因14例。而18F-FDG PET/MR/CT显像诊断真阳性38例,假阳性5例,假阴性3例,真阴性11例。18F-FDG PET/MR/CT的灵敏度92.7%,特异性68.8%;阳性预测值88.4%,阴性预测值78.6%。结论18F-FDG PET/MR/CT显像在临床FUO的诊疗中具有独特价值。

Objective To investigate value of ^18F-FDG positron emission tomography （PET）/ magnetic reso-nance （ MR）/ computed tomography （ CT） multimodality imaging in diagnosis of fever of unknown origin （ FUO） . Meth-ods PET/MR or PET/CT examination was performed for 57 patients fitted FUO diagnostic criteria from 2009 to 2014, and pathologic diagnosis was finally obtained by surgical exploration or puncture biopsy. Patients with clinical diagnosis without surgical treatment were followed up for over half a year. Diagnosed results by ^18F-FDG PET/MR/CT imaging were evaluated by visual and semiquantitative analysis methods. Results Among the 57 FUO patients, 43 patients were con-firmed pyrogens including 16 patients with infective inflammatory reaction, 12 patients with malignant tumor, 8 patients with non-infective inflammatory reaction and 7 patients with other types respectively;14 patients did not found pyrogens. ^18F-FDG PET/MR/CT imaging diagnosis showed 38 patients with true positive, 5 patients with false positive, 3 patients with false negative and 11 patients with true negative, and its sensitivity, specificity, positive and negative prediction val-ues were 92. 7%, 68. 8%, 88. 4% and 78. 6% respectively. Conclusion ^18F-FDG PET/MR/CT has special value in diagnosis and treatment of FUO.