^(18)F-FDG PET/CT鉴别诊断乳腺良恶性病变的价值

Value of 18F-FDG PET/CT on Differential Dignosis of Breast Benign and Malignant Lesions

目的评价氟-18脱氧葡萄糖正电子发射断层显像(^(18)F-FDG PET/CT)鉴别诊断乳腺良恶性病变的价值。方法 38例乳腺包块患者均行^(18)F-FDG PET/CT显像和乳腺钼靶检查,将诊断结果与术后病理结果进行比较、分析。结果本组38例患者均行手术和病理检查,病理确诊恶性肿瘤30例(浸润性导管癌25例,浸润性小叶癌4例,导管内原位癌1例),乳腺良性病变8例。^(18)F-FDG PET/CT诊断乳腺恶性肿瘤的灵敏度、特异性、准确度、阳性预测值和阴性预测值分别为90%(27/30)、75%(6/8)、86.8%(33/38)、93.1%(27/29)和66.7%(6/9);乳腺钼靶诊断乳腺恶性肿瘤的灵敏度、特异性、准确度、阳性预测值和阴性预测值分别为70%(21/30)、62.5%(5/8)、68.4%(26/38)、87.5%(21/24)和35.7%(5/14)。^(18)F-FDG PET/CT显像对比钼靶检查,二者在鉴别诊断乳腺良恶性病变的上述指标方面差异有统计学意义(P<0.05)。结论^(18)F-FDG PET/CT显像鉴别诊断乳腺良恶性病变优于乳腺钼靶检查,尤其是对于致密型乳腺有优势。

Objective To evaluate the value of fluorine-18 fluorodeoxyglucose positron emission tomography（^18F-FDG PET/CT） on differential diagnosis of breast benign and malignant lesions.Methods 38 cases patients with breast masses were all performed^18F-FDG PET/CT imaging and breast molybdenum target inspection and the diagnosis results and postoperative pathological results were compared and anlayzed.Results 38 patients in this group were all performed surgical and pathological examination and 30 were pathologically diagnosed as malignant tumor（ 25 cases invasive ductal carcinoma and 4 cases invasive lobular carcinoma,1 case ductal carcinoma in situ）,while 8 were breast benign lesions. The sensitivity、specificity、accuracy、positive predictive value and negative predictive value of^18F-FDG PET/CT in the diagnosis of breast malignant tumors were respectively 90%（ 27/30） 、75%（ 6/8） 、86. 8%（ 33/38） 、93. 1%（ 27/29） and 66. 7%（ 6/9）; The sensitivity、specificity、accuracy、positive predictive value and negative predictive value of breast molybdenum target in the diagnosis of breast malignant tumor were 70%（ 21/30） 、62. 5%（ 5/8） 、68. 4%（ 26/38） 、87. 5%（ 21/24） and 35. 7%（ 5/14）.As for^18F-FDG PET/CT imaging compared with molybdenum target,both had statistically significant difference on the differential diagnosis of breast benign and malignant lesions of all the above indicators（ P〈0. 05）.Conclusion^18F-FDG PET/CT imaging for differential diagnosis of breast benign and malignant lesions is superior to breast molybdenum target inspection,especially for dense breast.