18F-FDG-PET/CT 用于评估不明原因发热患者。
F-18 FDG-PET/CT in evaluation of patients with fever of unknown origin.
机构信息
Department of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
出版信息
Jpn J Radiol. 2013 May;31(5):320-7. doi: 10.1007/s11604-013-0190-z. Epub 2013 Mar 1.
OBJECTIVES
This study was carried out to evaluate the diagnostic utility of FDG-PET/CT in patients with fever of unknown origin (FUO).
METHODS
Medical records of 103 patients who underwent FDG-PET/CT and anatomic imaging as a part of FUO workup were analyzed. Final diagnosis of the cause of FUO was reached based on serologic assays, cultures, biopsy, surgery or 6 months of clinical follow-up.
RESULTS
The definite cause of fever was established in 69/103 patients. Abnormal FDG uptake was found in 63/103 patients and contributed to the final diagnosis (TP) in 62 patients (98.48 %). Of the remaining 40 patients with negative PET/CT, the final definite cause of fever (FN) could be determined only in seven patients (17.5 %). PET/CT had a sensitivity, specificity, positive predictive value and negative predictive value of 90, 97, 98.4 and 82.5 % compared to 43.5, 67.6, 73.2 and 37.1 %, respectively, for anatomic imaging. FDG-PET/CT had a higher accuracy (92.2 vs. 51.5 %; p = 0.003) compared to anatomic imaging for suggesting a cause of FUO.
CONCLUSIONS
PET/CT showed high sensitivity and specificity in suggesting a definite diagnosis in the evaluation of FUO.
目的
本研究旨在评估氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）在不明原因发热（FUO）患者中的诊断效用。
方法
分析了 103 例接受 FDG-PET/CT 检查和解剖影像学检查作为 FUO 检查一部分的患者的病历。FUO 的病因最终诊断基于血清学检测、培养、活检、手术或 6 个月的临床随访。
结果
69/103 例患者明确了发热的病因。103 例患者中有 63 例出现异常 FDG 摄取，这对 62 例患者（98.48%）的最终诊断（TP）有帮助。在其余 40 例 PET/CT 阴性的患者中，仅能确定 7 例（17.5%）的发热最终明确病因（FN）。与解剖影像学相比，PET/CT 的敏感性、特异性、阳性预测值和阴性预测值分别为 90%、97%、98.4%和 82.5%，而解剖影像学的敏感性、特异性、阳性预测值和阴性预测值分别为 43.5%、67.6%、73.2%和 37.1%。FDG-PET/CT 对于提示 FUO 的病因具有更高的准确性（92.2% vs. 51.5%；p=0.003）。
结论
在评估 FUO 时，PET/CT 对明确诊断具有较高的敏感性和特异性。
Zotero 插件