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18F-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)在不明原因发热患者中的诊断作用

The Diagnostic Role of FDG PET/CT in Patients with Fever of Unknown Origin.

作者信息

Ergül Nurhan, Halac Metin, Cermik Tevfik F, Ozaras Resat, Sager Sait, Onsel Cetin, Uslu Ilhami

机构信息

Istanbul University Cerrahpasa Faculty of Medicine, Department of Nuclear Medicine, İstanbul, Turkey.

出版信息

Mol Imaging Radionucl Ther. 2011 Apr;20(1):19-25. doi: 10.4274/MIRT.20.04. Epub 2011 Apr 1.

Abstract

OBJECTIVE

Fever of unknown origin (FUO) is a challenge for the physician and needs use of clinical, laboratory, and imaging studies and also invasive and/or non-invasive interventions to detect the etiology. The aim of present study was to assess the role of FDG PET/CT in determining the etiology in patients with FUO.

MATERIAL AND METHODS

Twenty-four patients (median age 52, range 5-77 years, 6 female, 18 male) who were diagnosed with FUO were retrospectively analyzed in this study. Before the FDG PET/CT studies, none of them had a definitive reason for their diseases investigated by conventional radiological or scintigraphic methods, clinical and laboratory observations.

RESULTS

The positive result was achieved in 19 (79.2%) of 24 patients as findings of the FDG PET/CT. However, FDG PET/CT was useful for definitive diagnosis in 12 (63.2%) of 19 positive patients. Malignant diseases were determined to be the underlying cause of FUO in 5 (41.6%) of 12 patients. Noninfectious inflammatory causes were detected in 2 (16.7%) patients, infections were exhibited in 3 (25%) patients, and miscellaneous diseases demonstrated in 2 (16.7%) patients. In 7 patients the detected pathological uptakes on FDG PET/CT were not helpful for the definitive diagnosis. In remaining 5 patients who showed no pathological uptake in the FDG PET/CT, diagnosis could not be established by other methods, as well. The sensitivity, specificity, and positive and negative predictive values for the determination of FUO etiology were 92.3%, 45.4%, 63.1%, and 100% for FDG PET/CT.

CONCLUSION

Our results demonstrate that FDG PET/CT seems to have considerable contribution to reveal the reason of undiagnosed patients with FUO investigated by conventional diagnostic methods, clinical and laboratory observations.

CONFLICT OF INTEREST

None declared.

摘要

目的

不明原因发热(FUO)对医生来说是一项挑战,需要运用临床、实验室及影像学检查,以及侵入性和/或非侵入性干预手段来查明病因。本研究的目的是评估氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描(FDG PET/CT)在确定FUO患者病因方面的作用。

材料与方法

本研究对24例被诊断为FUO的患者(年龄中位数52岁,范围5 - 77岁,女性6例,男性18例)进行了回顾性分析。在进行FDG PET/CT检查之前,通过传统放射学或闪烁扫描方法、临床及实验室观察,均未明确其疾病的病因。

结果

24例患者中,19例(79.2%)的FDG PET/CT检查结果为阳性。然而,在19例阳性患者中,FDG PET/CT对明确诊断有帮助的有12例(63.2%)。12例患者中有5例(41.6%)的潜在病因被确定为恶性疾病。2例(16.7%)患者检测出非感染性炎症病因,3例(25%)患者表现为感染,2例(16.7%)患者为其他杂病。7例患者FDG PET/CT检测到的病理性摄取对明确诊断无帮助。其余5例FDG PET/CT未显示病理性摄取的患者,也无法通过其他方法确诊。FDG PET/CT对确定FUO病因的敏感性、特异性、阳性预测值和阴性预测值分别为92.3%、45.4%、63.1%和100%。

结论

我们的结果表明,FDG PET/CT似乎对通过传统诊断方法、临床及实验室观察仍未确诊的FUO患者查明病因有很大贡献。

利益冲突

未声明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bf1/3590939/94185a22c947/MIRT-20-19-g3.jpg

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