^(18)F-FDG PET-CT对椎管内病变的诊断价值

The diagnostic values of ^(18)F-FDG PET/CT in spinal canal disease

目的 :探讨^(18)F-FDG PET-CT对椎管内良恶性病变的诊断价值。方法 :回顾性分析PET-CT提示椎管疾病患者41例。测量病变标准摄取最大值(SUV_(max)),并与术后病理或随访结果做对比。绘制ROC曲线获得椎管良恶性病变的SUV_(max)最佳诊断阈值。采用SPSS 20.0软件分析,计算^(18)F-FDG PET-CT在SUV_(max)>2.5诊断标准时的敏感度、特异度、阳性预测值、阴性预测值。结果:术后病理及随访得出良性15例,恶性26例,在SUV_(max)>2.5标准时,^(18)F-FDG PET-CT诊断良性7例,恶性34例,诊断敏感度100.00%、特异度46.67%、阳性预测值76.47%、阴性预测值100.00%。利用ROC曲线确定SUV_(max)的诊断阈值以2.95最佳,敏感度100.00%、特异度60.00%、阳性预测值81.25%、阴性预测值100.00%。结论 :SUV_(max)>2.95较SUV_(max)>2.5可能更适合作为判断椎管内病变良恶性的标准。

Objective：To investigate the value of18 F-FDG PET/CT imaging in the diagnosis of benign and malignant disease in the spinal canal disease. Methods：A retrospective analysis was conducted of 41 patients with vertebral canal disease through PET/CT imaging. SUV_（max）was measured and compared with postoperative pathology or follow-up of 6 months. The ROC curve was drawn to obtain the best diagnostic threshold of SUV_（max）for benign and malignant spinal canal diseases. The sensitivity,specificity,positive predictive value and negative predictive value of this data were calculated in SUV_（max） 2.5 diagnostic criteria.Results：In this study,postoperative pathology and follow-up found 15 benign cases and 26 malignant cases. In SUV_（max） 2.5 standard,7 cases were diagnosed as benign,34 cases were malignant. The sensitivity,specificity,positive predictive value and negative predictive value of18 F-FDG PET/CT were 100.00%,46.67%,76.47% and 100.00% respectively. The sensitivity,specificity,positive predictive value and negative predictive value at the SUV_（max） value of 2.95 were 100.00%,60.00%,81.25%,and100.00%. It was confirmed that the SUV_（max）value of 2.95 was the optical threshold by ROC curve. Conclusion：SUV_（max） 2.95 rather than SUV_（max） 2.5 may be more appropriate as the standard for the diagnosis of malignant disease in vertebral canal disease in clinical work.