闫港;王明华;
YAN Gang;WANG Minghua;Department of Nuclear Medicine, the Affiliated Hospital of Guizhou Medical University;

• 1:贵州医科大学附院核医学科
• 2:贵州医科大学医学影像学院

摘要(Abstract)：

目的:探讨氟代脱氧葡萄糖正电子发射型计算机体层成像(⁽¹⁸⁾F-FDG PET/CT)对17～44岁青年患者良恶性肺内孤立性结节(SPN)的鉴别诊断价值。方法:经病理证实或影像学检查随访2年以上确诊的79例青年SPN患者,其中肺癌44例、良性病变35例;采用(18)F-FDG PET/CT)对17～44岁青年患者良恶性肺内孤立性结节(SPN)的鉴别诊断价值。方法:经病理证实或影像学检查随访2年以上确诊的79例青年SPN患者,其中肺癌44例、良性病变35例;采用⁽¹⁸⁾F-FDG PET/CT检测病灶形态、测量(18)F-FDG PET/CT检测病灶形态、测量⁽¹⁸⁾F-FDG最大标准化摄取值(SUVmax),比较良恶性SPN患者SUVmax;绘制受试者工作特征曲线(ROC),分析SUVmax诊断恶性SPN的敏感性、特异性及最佳SUVmax界值,比较良恶性SPN的(18)F-FDG最大标准化摄取值(SUVmax),比较良恶性SPN患者SUVmax;绘制受试者工作特征曲线(ROC),分析SUVmax诊断恶性SPN的敏感性、特异性及最佳SUVmax界值,比较良恶性SPN的⁽¹⁸⁾F-FDG PET/CT特点,回归分析(18)F-FDG PET/CT特点,回归分析⁽¹⁸⁾F-FDG PET/CT征象及SUVmax对恶性SPN的预测价值。结果:恶性SPN患者SUVmax高于良性SPN患者(P<0.05),ROC曲线分析显示SUVmax诊断恶性SPN的最佳界值为2.9、敏感度为0.977、特异度为0.343;(18)F-FDG PET/CT征象及SUVmax对恶性SPN的预测价值。结果:恶性SPN患者SUVmax高于良性SPN患者(P<0.05),ROC曲线分析显示SUVmax诊断恶性SPN的最佳界值为2.9、敏感度为0.977、特异度为0.343;⁽¹⁸⁾F-FDG PET/CT图像中,恶性SPN分叶、毛刺、胸膜牵拉凹陷征及SUVmax≥2.9的出现率高于良性SPN(P<0.05),回归分析显示胸膜牵拉凹陷征及SUVmax≥2.9是恶性SPN的危险因素(P<0.05)。结论:(18)F-FDG PET/CT图像中,恶性SPN分叶、毛刺、胸膜牵拉凹陷征及SUVmax≥2.9的出现率高于良性SPN(P<0.05),回归分析显示胸膜牵拉凹陷征及SUVmax≥2.9是恶性SPN的危险因素(P<0.05)。结论:⁽¹⁸⁾F-FDG PET/CT鉴别良恶性青年SPN敏感度高,胸膜牵拉凹陷征及SUVmax可用于预测恶性SPN。
Objective: To investigate the diagnostic value of (18)F-FDG PET/CT鉴别良恶性青年SPN敏感度高,胸膜牵拉凹陷征及SUVmax可用于预测恶性SPN。
Objective: To investigate the diagnostic value of ⁽¹⁸⁾F-FDG position emission tomography/computed tomography(PET/CT) for young patients with differentiating solitary pulmonary nodule(SPNs). Methods: A retrospective analysis of 79 cases of SPN with PET/CT under 44 years of age confirmed by CT from July 2013 to November 2018 was conducted. Each case with SPN was confirmed pathologically or received imaging examination follow-up for more than 2 years. Differential diagnosis of SPNs was made using morphological features in HRCT, visually detectable metabolism and semi-quantitative method.Results: Out of the 79 patients, 44 were diagnosed as cases with lung cancer and 35 with benign lesions, 50 males and 29 females, aged 17～44 years, with a median age of 34 years. The maximum standard uptake value(SUVmax) of the nodules was significantly higher in the malignant group than in the benign group(t=-7.287,P<0.05). The best SUV threshold for the diagnosis of the malignant nodules by ROC curve analysis was SUVmax≥2.9. The best index for the diagnosis of malignant nodules by regression analysis was pleural traction depression sign and SUVmax value≥2.9. Conclusion: (18)F-FDG position emission tomography/computed tomography(PET/CT) for young patients with differentiating solitary pulmonary nodule(SPNs). Methods: A retrospective analysis of 79 cases of SPN with PET/CT under 44 years of age confirmed by CT from July 2013 to November 2018 was conducted. Each case with SPN was confirmed pathologically or received imaging examination follow-up for more than 2 years. Differential diagnosis of SPNs was made using morphological features in HRCT, visually detectable metabolism and semi-quantitative method.Results: Out of the 79 patients, 44 were diagnosed as cases with lung cancer and 35 with benign lesions, 50 males and 29 females, aged 17～44 years, with a median age of 34 years. The maximum standard uptake value(SUVmax) of the nodules was significantly higher in the malignant group than in the benign group(t=-7.287,P<0.05). The best SUV threshold for the diagnosis of the malignant nodules by ROC curve analysis was SUVmax≥2.9. The best index for the diagnosis of malignant nodules by regression analysis was pleural traction depression sign and SUVmax value≥2.9. Conclusion: ⁽¹⁸⁾F-FDG PET/CT plays an important role in differentiating benign and malignant SPN in young patients. SUVmax value combined with HRCT sign can obviously improve the diagnostic efficacy of SPN, and PET/CT can provide effective diagnosis and treatment of SPN.

关键词(KeyWords)： 青年;孤立性肺结节;正电子发射型计算机体层成像;X线计算机;体层摄影术;诊断价值
young patients;solitary pulmonary nodules;positron emission computer tomograghy;X-ray computed;tomography;diagnosis value

Abstract:

Keywords:

基金项目(Foundation): 贵州省科学技术基金[黔科合LH字(2016)7347]

作者(Authors): 闫港;王明华;
YAN Gang;WANG Minghua;Department of Nuclear Medicine, the Affiliated Hospital of Guizhou Medical University;

DOI: 10.19367/j.cnki.1000-2707.2019.11.018

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