符合线路SPECT在消化系统肿瘤术后复发转移中的应用研究

Study of Clinical Application of 18F - FDG SPECT with Coincidence in the Recurrent or Metastatic Tumor of Digestive System

目的:探讨18F-FDG符合线路SPECT在消化系统肿瘤术后复发转移中的临床应用价值。材料和方法:对35例临床怀疑复发转移的消化系统肿瘤术后患者行18F-FDG符合线路SPECT显像,对其显像结果进行分析,计算其诊断的准确率、灵敏度、特异性、阳性预测值、阴性预测值及其95％可信区间,并与B超、CT、MRI的诊断结果相比较。结果:在35例消化系统肿瘤术后患者中,其诊断的准确率、灵敏度、特异性、阳性预测值、阴性预测值分别为91.4％、88.9％、100％、100％、72.7％;其95％可信区间分别为77％-98％、71％-98％、63％-100％、86％-100％、39％-94％。符合线路SPECT的诊断准确率、灵敏度明显高于B超,与CT和MRI的比较尚无显著性差异;95％可信区间分析,结果显示符合线路SPECT高于B超、CT和MRI;18F-FDG符合线路SPECT和B超、CT、MRI联合应用在某些病例的诊断中具有互补性。结论:18F-FDG SPECT/PET显像在消化系统肿瘤术后复发转移的诊断中具有较高的临床应用价值。

Purpose: To investigate the clinical value of 18F - FDG SPECT with coincidence in the diagnosis of recurrent or metastatic tumor of digestive system. Materials and Methods: 35 cases of postoperative patients with tumor of digestive system were enrolled in this study with 18F - FDG SPECT with coincidence. The results were analyzed by calculating its accuracy, sensitivity, specificity, positive predictive value (PPV) , negative predictive valu (NPV) , 95% confidence interval and compared with US, CT and MRI. Results: In 35 cases of postoperative patients with tumor of digestive system, the accuracy, sensitivity, specificity,PPV and NPV were 91.4% ,88.9% , 100% , 100% ,72.7% , respectively, and their 95% confidence interval were 77% - 98% , 71% - 98% , 63% - 100% , 86% - 100% , 39% - 94% , respectively. The diagnostic accuracy and sensitivity of 18F - FDG SPECT with coincidence were significantly higher than that of US, while there were no significant difference between the result of other 18F- FDG SPECT with coincidence and CT and MRI. The analysis of 95% confidence interval showed a higher tendency in 18F _ FDG SPECT with coincidence than in US, CT and MRI. There is complementation among 18F - FDG SPECT with coincidence combined with UB, CT and MRI in some cases. Conclusion:18F- FDG SPECT/ PET has high clinical value in the diagnosis of recurrent or metastatic tumor of digestive system.