摘要
目的评价18氟-氟代脱氧葡萄糖正电子发射计算机断层扫描(18F-FDG PET/CT)的最大标准化摄取值(SUVmax)对肺内病灶鉴别诊断的价值,并寻找其最佳诊断界值;探讨病灶大小、病理类型对SUVmax的影响。方法 134例患者行18F-FDG PET/CT显像,采集注射18F-FDG后50分钟PET/CT全身图像,将显像结果进行半定量分析并与病理结果或治疗随访结果对照,用受试者工作特征曲线(ROC)分析法评价SUVmax对肺部病变良、恶性鉴别诊断的效能;通过散点图和协方差分析等统计方法研究病灶的大小、病理类型对病灶SUVmax的影响。结果肺内病灶恶性病变组的SUVmax高于良性病变组(t=6.327,P<0.05);ROC曲线上SUVmax的最佳界点为4.16,以SUVmax>4.16作为诊断良恶性的阈值,其灵敏度和特异度分别为0.88和0.82;绘制散点图以分析病灶大小对SUVmax的影响,结果表明病灶大小与病灶SUVmax之间存在显著的相关性(r=0.510,P<0.05);在分析腺癌、鳞癌、结核等病理类型对SUVmax的影响时,通过协方差分析修正病灶大小的影响后,鳞癌组SUVmax大于结核组且差异有统计学意义(P<0.05),其他各组间差异无统计学意义(P>0.05)。结论 PET/CT的SUVmax对肺部病灶良恶性的鉴别诊断具有较大的临床应用价值,SUVmax的诊断界值受多种因素的影响,单纯以SUV≥2.5作为标准存在不足。
Objective To evaluate the values of 18f-FDG PET/CT maximal standardization of receiving values （SUVmax） in the differential diagnosis of pulmonary lesions,and to look for the best diagnostic boundary value and to discuss the influences of lesion size, and to determine the effects of pathological type on SUVmax. Methods 134 patients undergoing 18f FDG PET/CT imaging, after injection of 18f-FDG, 50 rain PET/CT images were collected. The imaging results were analyzed using semi-quantitative analysis and they were compared with the follow-up treatment results and pathology results. The receiver-operating characteristic curve （ROC） analysis was used to evaluate differential diagnostic effectiveness of SUVmax to benign and malignant lung lesions. The scatter diagram and the covariance analysis were taken as the statistical methods, the size of the lesions and the effects of pathological type on SUVmax were also studied. Results SUVmax in lung malignant lesions group was higher than that in benign lesions group （ t =6. 327, P 〈0.05） ,the best cutoff point was 4.16 for SUVmax on ROC curves,SUVmax〉4.16 was taken as the diagnosis of benign and malignant threshold, the sensitivity and speciality were 0.88 and 0.82, respectively. The scatter diagram was used to analyze the effect of lesion size on SUVmax,the results showed that there was significant association between the lesions SUVmax and the lesion size（ r = 0. 510, P 〈 0. 05 ） ; Based on the effects of the pathological type such as adenocarcinoma, squamous carcinoma, tuberculosis on SUVmax, the covariance analysis was used to adjust the effects of size,SUVmax in squamous cell carcinomas was greater than the tuberculosis group and the difference was statistically significant （ P 〈0.05）. There was no statistically significant difference between the other groups（ P 〉0.05）. Conclusion PET/CT maximal standardization of SUVmax had great clinical application value in the differential diagnosis of benign and malignant lung lesions, SUVmax diagn
出处
《临床荟萃》
CAS
2014年第4期395-399,共5页
Clinical Focus
基金
新疆维吾尔自治区自然科学基金(2012211A081)
