18F-FDG PET/CT 在结核性胸膜炎诊断及结核性胸膜炎与肺腺癌胸膜转移鉴别诊断中的价值。
The Value of 18F-FDG PET/CT in the Diagnosis of Tuberculous Pleurisy and in the Differential Diagnosis between Tuberculous Pleurisy and Pleural Metastasis from Lung Adenocarcinoma.
机构信息
Nuclear Medicine Department of the Affiliated Hospital of Jiangnan University, Wuxi, China.
Respiratory Medicine Department of the Fifth People's Hospital of Wuxi (Infectious Disease Hospital of Wuxi), Wuxi, China.
出版信息
Contrast Media Mol Imaging. 2022 Jul 31;2022:4082291. doi: 10.1155/2022/4082291. eCollection 2022.
OBJECTIVES
This study aims to investigate the diagnostic value of 18F-FDG PET/CT in tuberculous pleurisy (TBP) and the differential diagnostic value of 18F-FDG PET/CT between TBP and pleural metastasis from lung adenocarcinoma (PMLAC).
MATERIALS AND METHODS
The features of pleura on PET and hybrid CT were retrospectively studied in 20 patients with TBP and 32 patients with PMLAC. The ROC curve was used to evaluate the diagnostic effectiveness of these indices for TBP and PMLAC, and binary logistic regression analysis was conducted to identify independent predictors of TBP and PMLAC.
RESULTS
There were significant differences in pleural 18F-FDG uptake pattern on PET (=0.001), pleural morphology pattern on CT (=0.002), the maximum diameter of the pleural nodule (=0.001), and interlobular fissure nodule (=0.001) between TBP and PMLAC groups. The diffused pleural FDG uptake type on PET (odds ratio (OR) = 6.0, 95% CI 2.216-16.248, =0.001) and the lamellar pleural thickening type on CT (OR = 4.4, 95% CI 2.536-7.635, =0.001) were independent predictors of TBP, with 60% and 55% sensitivity, 96.6% and 90.6% specificity, and 82.7% and 77.0% accuracy. The combined diagnostic sensitivity, specificity, and accuracy for TBP were 70%, 87.5%, and 80.8%. The mixed pleural FDG uptake type on PET (OR = 5.106, 95% CI 2.024-12.879, =0.001), the mixed pleural thickening type on CT (OR = 2.289, 95% CI 1.442-3.634, =0.001), and the maximum diameter of the pleural nodule (OR = 1.027, 95% CI 1.012-1.042, =0.001) were independent predictors of PMLAC, with 78.1%, 71.9%, and 87.5% sensitivity, 85%, 80%, and 85% specificity, and 80.8%, 75%, and 86.5% accuracy. The combined diagnostic sensitivity, specificity, and accuracy for PMLAC were 96.9%, 85%, and 90.4%.
CONCLUSIONS
18F-FDG PET/CT is of great clinical value in the diagnosis of TBP and in the differential diagnosis between TBP and PMLAC.
目的
本研究旨在探讨 18F-FDG PET/CT 对结核性胸膜炎（TBP）的诊断价值，以及其对 TBP 和肺腺癌胸膜转移（PMLAC）的鉴别诊断价值。
材料与方法
回顾性分析 20 例 TBP 患者和 32 例 PMLAC 患者的胸腔 18F-FDG PET 和混合 CT 特征。采用受试者工作特征（ROC）曲线评估这些指标对 TBP 和 PMLAC 的诊断效能，并通过二元逻辑回归分析确定 TBP 和 PMLAC 的独立预测因子。
结果
TBP 组和 PMLAC 组在胸腔 18F-FDG 摄取模式（=0.001）、CT 胸膜形态模式（=0.002）、胸膜结节最大直径（=0.001）和叶间裂结节（=0.001）方面存在显著差异。PET 上弥漫性胸腔 FDG 摄取类型（比值比（OR）=6.0，95%置信区间 2.216-16.248，=0.001）和 CT 上板层胸膜增厚类型（OR=4.4，95%置信区间 2.536-7.635，=0.001）是 TBP 的独立预测因子，具有 60%和 55%的灵敏度、96.6%和 90.6%的特异性以及 82.7%和 77.0%的准确性。TBP 的联合诊断灵敏度、特异性和准确性分别为 70%、87.5%和 80.8%。PET 上混合性胸腔 FDG 摄取类型（OR=5.106，95%置信区间 2.024-12.879，=0.001）、CT 上混合性胸膜增厚类型（OR=2.289，95%置信区间 1.442-3.634，=0.001）和胸膜结节最大直径（OR=1.027，95%置信区间 1.012-1.042，=0.001）是 PMLAC 的独立预测因子，具有 78.1%、71.9%和 87.5%的灵敏度、85%、80%和 85%的特异性以及 80.8%、75%和 86.5%的准确性。PMLAC 的联合诊断灵敏度、特异性和准确性分别为 96.9%、85%和 90.4%。
结论
18F-FDG PET/CT 对 TBP 的诊断和 TBP 与 PMLAC 的鉴别诊断具有重要的临床价值。
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