18F-PET/CT在肺磨玻璃结节诊断中的应用

Clinical value of 18F-PET/CT for diagnosis of pulmonary ground-glass opacity nodules

关键词:  磨玻璃结节  肺  ¹⁸F-FDG PET/CT

Key words:  ground-glass nodules  lung  ¹⁸F-FDG PET/CT

摘要:

目的 探讨肺恶性磨玻璃结节(ground-glass opacity, GGO)的¹⁸F-FDG PET/CT影像学特点及¹⁸F-FDG PET/CT鉴别肺GGO良恶性的诊断价值。方法 对82例行PET/CT检查的肺GGO患者的临床资料及PET/CT影像学特点行回顾分析,其中51例患者均经手术病理确诊,31例随访疗效后明确诊断。结果 82例患者中,50例为恶性病变,32例为良性病变。单因素分析显示,PET/CT下GGO的密度类型、分叶、边界、毛刺、胸膜凹陷征、充气空泡征以及标准摄取值(standardized up take value, SUV)平均值、最大值对于良恶性鉴别有意义。多因素分析显示,混合型GGO、边界不清GGO及分叶GGO是恶性GGO的预测因子。ROC曲线分析结果显示SUV最大值与平均值对于GGO的良恶性鉴别准确性较低(AUC=0.679、0.682)。结论 ¹⁸F-PET/CT对恶性GGO的诊断有良好的敏感性和特异性。

Abstract:

Objective To evaluate the application of ¹⁸F-FDG PET/CT imaging in diagnosis and differential diagnosis of lung ground-glass opacity(GGO) nodules. Methods The clinical data and PET/CT images of 82 patients with lung ground-glass opacity nodules were retrospectively reviewed. Among 82 cases the diagnosis was confirmed by operation and pathology in 51 cases and confirmed during follow-up in 31 cases. ResultsAmong 82 patients, 50 cases were malignant and 32 were benign. Univariate analysis showed that there were significant differences in density type, divided leaves on GGO PET/CT, boundary, burr, pleural indentation, inflatable vacuole sign, the average SUV values of SUV, SUV maximum between benign and malignant lesions. Multivariate analysis showed that mixed GGO, unclear boundary and leaf GGO was a predictor of malignancy. ROC curve showed that the accuracy of maximum SUV value and average value was low in differentiating benign and malignant GGO nodules(AUC=0.679,0.682). Conclusion ¹⁸F-PET/CT is highly sensitive and specific in diagnosis of malignant lung ground-glass nodules.