^(18)F-FDG-PET/CT显像在胰腺炎和胰腺癌鉴别诊断中的应用

The application of ^(18)F-FDG-PET/CT imaging in differential diagnosis of pancreatitis and pancreatic cancer

目的探讨^(18)F-FDG-PET/CT显像在鉴别诊断胰腺癌良恶性病变中的价值。方法选取我院2014年1月～2017年1月确诊的胰腺癌患者53例(恶性组)、慢性胰腺炎患者22(良性组),两组患者均接受了^(18)F-FDG-PET/CT显像检测,对比两组患者病灶早期、延迟期的最大标准摄取值(SUV),滞留指数(RI),并绘制受试者工作曲线(ROC)求取早期SUV、RI鉴别诊断胰腺癌的最佳临界值及对应的诊断学指标。结果恶性组的^(18)F-FDG-PET/CT显像早期SUV测定值、延迟期SUV测定值、RI值均显著的高于良性组患者,差异具有统计学意义(P <0. 05);当选取早期SUV的临界值为3. 07时,^(18)F-FDG-PET/CT显像诊断灵敏度为78. 82%、特异度为86. 14%、漏诊率为21. 18%、误诊率为13. 86%、AUC值为0. 846;当选取RI的临界值为14. 46时,^(18)F-FDG-PET/CT显像诊断灵敏度为87. 64%、特异度为95. 20%、漏诊率为12. 36%、误诊率为4. 80%、AUC值为0. 911。结论^(18)F-FDG-PET/CT显像在鉴别诊断胰腺癌良恶性病变中具有较高的临床实用价值。

Objective To explore the value of ^18F-FDG-PET/CT imaging in the differential diagnosis of benign and malignant pancreatic cancer. Methods We selected 53 patients with pancreatic cancer （malignant group） and 22 patients with chronic pancreatitis （benign group） who were diagnosed in our hospital from January 2014 to January 2017. Patients in our hospital from underwent ^18F-FDG PET/CT imaging to compare the maximum standard uptake value （SUV） and retention index （RI） of early and delayed lesions in the two groups. We drew the receiver operating curve （ ROC ） to obtain the best cut-off value and corresponding diagnostic indicators of early SUV, RI differential diagnosis of pancreatic cancer. Results The early SUV value, delayed SUV value and RI value of ^18F-FDG-PET/CT imaging in malignant group are significantly higher than those in benign group, the difference is statistically significant （ P 〈 0.05 ）. When the critical value of early SUV is 3.07, the sensitivity of ^18F-FDG- PET/CT imaging is 78.82% , specificity is 86.14% , the missed diagnosis rate is 21.18% , misdiagnosis rate is 13.86% , and AUC value is 0. 846. When the critical value of RI is 14.46, the sensitivity of ^18F-FDG-PET/CT imaging is 87.64% , the specificity is 95.20% , the missed diagnosis rate is 12.36% , the misdiagnosis rate is 4. 80% , and the AUC value is 0.911. Conclusion ^18F-FDG-PET / CT imaging in the differential diagnosis of benign and malignant pancreatic cancer has a high clinical value.