^(18)F-FDG PET-CT对不同密度孤立性肺结节的诊断价值

Diagnostic value of^(18)F-FDG PET-CT in solitary pulmonary nodule with different densities

目的:探讨^(18)F-FDG PET-CT对不同密度孤立性肺结节(SPN)的诊断价值。方法:选取188例行PET-CT的SPN患者,依据是否含实性成分分成A组(纯磨玻璃密度结节)、B组(混合磨玻璃密度结节)、C组(实性结节)。计算区分密度前后诊断恶性SPN的最大标准化摄取值(SUV_(max))的截断值,将诊断结果与病理、随访结果对比。结果:A、B、C组的SUV_(max)截断值分别为0.60、1.35、3.56,未区分密度的SUV_(max)截断值为2.65;A、C组内恶性结节的SUV_(max)均大于良性结节(均P<0.05);C组恶性结节的SUV_(max)均大于A、B组(均P<0.05),而A、B组的恶性结节间差异无统计学意义(P=0.31)。C组恶性结节的最大截面长径(R)大于良性结节(P<0.001),A、B组组内良恶性结节的R值差异无统计学意义(P>0.05)。绘制SPN是否区分密度时的ROC曲线,得出AUC均>0.5;不区分密度时的R值及SUV_(max)的AUC分别为0.748和0.764(均P<0.05)。区分密度时,A组仅特异度降低。恶性实性结节病理亚组分析显示,鳞状细胞癌的R值、SUV_(max)均大于腺癌(均P<0.05)。结论:选择PET-CT的SUV_(max)诊断恶性SPN,区分密度时有更高的诊断效能。

Objective:To explore the diagnostic value of PET-CT in solitary pulmonary nodule(SPN)with different densities.Methods:A total of 188 SPNs in PET-CT were evaluated and divided into Group A(pure ground-glass nodules),Group B(mixed ground-glass nodules),and Group C(solid nodules)according to whether it contains solid component.The cut-off values of_(max)imum standardized uptake value(SUV_(max))of malignant SPNs diagnosed before and after grouping,were calculated,and the diagnosis results were compared with pathological and follow-up results.Results:The SUV_(max)cut-off values of Group A,B,and C were 0.6,1.35,3.56,and SUV_(max)cut-off value of undifferentiated density was 2.65.The SUV_(max)of malignant nodules in Group A and C were greater than that of the benign nodules(both P<0.05);the SUV_(max)of malignant nodules in Group C was greater than those in Group A and B(both P<0.05),and the difference between SUV_(max)of malignant nodules in Group A and that in Group B was not statistically significant(P=0.31).The largest cross-sectional length(R value)of malignant nodules in Group C was greater than that of benign nodules(P<0.001)and the differences of R value between benign and malignant nodules in Group A and B were not statistically significant(P>0.05).Draw the ROC curve before and after grouping and the AUC values were both greater than 0.5.The AUC values of R value and SUV_(max)before grouping were 0.748 and 0.764 respectively(P<0.05).The specificity of Group A was reduced after grouping.Pathological subgroup analysis of malignant solid nodules showed that the R value and SUV_(max)of squamous cell carcinoma were greater than those of adenocarcinoma(both P<0.05).Conclusions:The diagnostic efficacy of SUV_(max)for malignant SPN is high when pulmonary nodules are classified based on density.