18F-FDG PET/CT联合同机HRCT对肺磨玻璃结节的诊断价值

Value of 18F-FDG PET/CT combined with the same scanner HRCT in the diagnosis of pulmonary ground-glass nodules

    摘要
  • 摘要:
    目的探讨18F-FDG PET/CT联合同机高分辨率CT（HRCT）对肺磨玻璃结节的诊断价值。
    方法回顾性分析经手术病理或临床随访证实的72例肺磨玻璃结节患者（恶性40例、良性32例）资料，对其临床资料、影像特征、SUVmax等参数进行统计学分析。
    结果单因素分析结果显示，HRCT下肺磨玻璃结节的直径（t=4.932，P < 0.001）、密度（χ2=29.425，P < 0.001）、分叶征（χ2=9.626，P=0.002）、毛刺征（χ2=7.605，P=0.006）、胸膜凹陷征（χ2=4.585，P=0.032）、血管集束征（χ2=7.605，P=0.006）及SUVmax（t=3.884，P < 0.001）在良、恶性两组间差异均有统计学意义。而性别（χ2=0.026，P=0.873）、年龄（t=1.417，P=0.161）、空泡征（χ2=3.214，P=0.073）及空气支气管征（χ2=1.664，P=0.197）在两组间差异均无统计学意义。多因素分析结果显示，混合型密度是鉴别良恶性病变的显著预测因子（χ2=10.261，OR=23.515，P < 0.05）。受试者工作特征曲线分析结果显示，以结节直径≥11 mm、SUVmax≥0.9为评判指标具有较好的鉴别精度。HRCT、PET/CT及PET/CT联合HRCT对肺磨玻璃结节诊断的灵敏度分别为75.0%、82.5%、90.0%，特异度分别为81.3%、78.1%、68.8%，准确率分别为77.8%、80.6%、80.6%。
    结论18F-FDG PET/CT联合HRCT通过对肺磨玻璃结节的代谢情况及影像学分析，对其鉴别诊断有一定的临床价值，两者联合使用可以提高诊断的灵敏度。

     

    Abstract:
    ObjectiveTo investigate the value of 18F-FDG PET/CT combined with the same scanner high resolution CT (HRCT) in the diagnosis of pulmonary ground-glass nodules (GGNs).
    MethodsA total of 72 patients with pulmonary GGNs (40 cases were malignant, 32 presented benign lesions) were retrospectively analyzed and confirmed by surgical pathology or clinical follow-up.The clinical data, imaging features, maximum standardized uptake value (SUVmax) were analyzed statistically.
    ResultsUnivariate analysis showed significant differences in diameter (t=4.932, P < 0.001), density type (χ2=29.425, P < 0.001), lobular sign (χ2=9.626, P=0.002), spiculation sign (χ2=7.605, P=0.006), pleural indentation (χ2=4.585, P=0.032), vascular convergence (χ2=7.605, P=0.006), and SUVmax(t=3.884, P < 0.001).By contrast, no differences in gender (χ2=0.026, P=0.873), age (t=1.417, P=0.161), vacuole sign (χ2=3.214, P=0.073), and air bronchus sign (χ2=1.664, P=0.197) were observed between the two groups in HRCT.Multivariate analysis showed that mixed density was a notable predictor of malignancy (χ2=10.261, OR=23.515, P < 0.05).The receiver operating characteristic curve showed the diameter ≥ 11 mm and SUVmax ≥ 0.9 as the standard reference indexes that yielded good identification accuracy.The sensitivity of HRCT, PET/CT, and PET/CT combined with the same scanner HRCT in the diagnosis of GGNs were 75.0%, 82.5%, and 90.0%, with specificity values of 81.3%, 78.1%, and 68.8% and accuracy of 77.8%, 80.6%, and 80.6%, respectively.
    Conclusions18F-FDG PET/CT combined with the same scanner HRCT present certain clinical value in the differential diagnosis of GGNs by analyzing the metabolic condition and imaging characteristics.This approach can improve diagnostic sensitivity.

     

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