18F-FDG PET/CT联合肺动脉灌注成像指数在单发肺结节中的应用价值

Application of the 18F-FDG PET/CT and pulmonary artery perfusion index to diagnose the single pulmonary nodules

目的探讨18F-FDG PET/CT联合320容积CT双入口灌注成像(DI-CTP)肺动脉灌注指数(PPI)对单发性肺结节的鉴别诊断价值。方法搜集经病理证实40例单发性肺结节患者的18F-FDG PET/CT及320排CT灌注成像影像资料(恶性结节24例、良性结节16例),PET/CT以结节18F-FDG摄取值SUV≥2.5为诊断恶性结节阈值,18F-FDG PET/CT联合PPI则在SUV≥2.5诊断阈值的基础上综合PPI<50%判定,并分析SUV与PP均值在良恶性结节间差异性及相关性。结果PET/CT联合PPI正确诊断38例,其中恶性结节22例、良性结节16例,误诊2例。18F-FDG PET/CT联合PPI诊断肺单发结节的敏感性91.6%,特异性100%,准确性95.0%;18F-PDG摄取值SUV在良、恶性结间差异无统计学意义(t=1.66,P>0.05),而PPI均值在良、恶性结节间差异有统计学意义(t=-3.14,P<0.01);SUV与PPI间相关性无统计学意义(r=0.20,P>0.05)。结论18F-FDG PET/CT联合PPI可以提高诊断肺单发肺结节敏感性、特异性和准确性,减少误诊率。

Objective To investigate application of 18F-FDG PET/CT maximum standard uptake value(SUV)combined with pulmonary artery perfusion index(PPI)in the differential diagnosis of single pulmonary nodule on 320-row CT double-entry perfusion imaging(DI-CTP).Methods 40 single pulmonary nodules including the 18F-FDG PET/CT and DI-CTP imaging data confirmed by pathology(24 cases of malignant nodules and 16 cases of benign nodules)were collected.The diagnostic threshold of 18F-FDG for malignant nodules was SUV(≥2.5)on the basis of PPI<50%,and the difference and correlation between benign and malignant nodules on SUV and PPI were also analyzed.Results Thirty-eight cases were correctly diagnosed by 18F-PDG PET/CT combined with PPI,including 22 malignant nodules,and 16 cases of benign nodules,but 2 case was misdiagnosed.The sensitivity,specificity and accuracy of 18F-PDG PET/CT combined with PPI in the diagnosis of single pulmonary nodules were 91.6%,100%and 95%,respectively.There was no significant difference between benign and malignant nodules in SUV(t=1.66,P>0.05),but there was significant difference in PPI between benign and malignant nodules(t=-3.14,P<0.01).There was no significant correlation between SUV and PPI(r=0.20,P>0.05).Conclusion Application of 18F-FDG PET/CT combined with PPI in the diagnosis of single pulmonary nodules can greatly improve the diagnostic the sensitivity,specificity and accuracy,and reduce the misdiagnosis rate.