¹⁸F-FDG-PET/CT 在高发结核地区孤立性肺结节中的鉴别诊断价值。

The value of ¹⁸F-FDG-PET/CT in the differential diagnosis of solitary pulmonary nodules in areas with a high incidence of tuberculosis.

机构信息

Department of Respiratory Medicine, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu 610041, China.

出版信息

Ann Nucl Med. 2011 Dec;25(10):804-11. doi: 10.1007/s12149-011-0530-y. Epub 2011 Aug 31.

DOI:10.1007/s12149-011-0530-y

PMID:21879296

Abstract

OBJECTIVE

The purpose of this study was to evaluate (18)F-FDG-PET, PET/CT, and CT in the diagnosis of benign or malignant solitary pulmonary nodules (SPNs) in areas with a high incidence of TB.

METHODS

Ninety-six patients with a SPN smaller than 30 mm were studied prospectively. PET/CT images were obtained 60 min after intravenous injection of (18)F-FDG. The data obtained for each patient were analyzed and the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated and compared using χ(2) test.

RESULTS

The sensitivity, specificity, accuracy, PPV, and NPV in the diagnosis of SPN were 86.7, 72.2, 81.3, 83.9, and 76.5%, respectively, for CT and 88.3, 61.1, 79.1, 79.1, and 75.9%, respectively, for PET. Tuberculosis was responsible for 57.1% (8/14) of false-positives on PET. The sensitivity, specificity, accuracy, PPV, and NPV in the diagnosis of SPN were 96.7, 75.7, 88.5, 88.1, and 94.4% for PET/CT. The accuracy of PET/CT was higher than that of either CT or PET alone (P < 0.05).

CONCLUSION

PET has a high false-positive rate in areas with a high incidence of TB; combined PET and CT (PET/CT) can improve the diagnostic accuracy in the differentiation of an SPN.

摘要

目的

本研究旨在评估（18）F-FDG-PET、PET/CT 和 CT 在高结核发病率地区诊断单发肺结节（SPN）的良恶性。

方法

前瞻性研究 96 例直径小于 30mm 的 SPN 患者。静脉注射（18）F-FDG 后 60min 行 PET/CT 扫描。分析每位患者的数据，采用卡方检验比较 CT、PET 和 PET/CT 诊断 SPN 的准确性、敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。

结果

CT 诊断 SPN 的敏感度、特异度、准确性、PPV 和 NPV 分别为 86.7%、72.2%、81.3%、83.9%和 76.5%，PET 分别为 88.3%、61.1%、79.1%、79.1%和 75.9%。PET 假阳性中有 57.1%（8/14）为结核。PET/CT 诊断 SPN 的敏感度、特异度、准确性、PPV 和 NPV 分别为 96.7%、75.7%、88.5%、88.1%和 94.4%。PET/CT 的准确性高于 CT 或 PET 单独检测（P<0.05）。