18F-FDG PET/CT显像在肾上腺转移瘤中的诊断价值和预测分析

18F-FDG PET/CT diagnostic value and predictive analysis in adrenal metastasis lesions

    摘要
  • 摘要:
    目的探讨18F-FDG PET/CT显像在肾上腺转移瘤中的诊断价值及预测价值。
    方法回顾性分析2012年12月至2016年10月行PET/CT检查的95例无症状的肾上腺病变患者，分为肾上腺转移瘤组（40例）和肾上腺良性病变组（55例），分别测量肾上腺病灶大小、CT值、最大标准化摄取值（SUVmax）、肾上腺病灶SUVmax/肝脏本底SUVmax比值（SUVmax比值），分别进行单因素检验、独立样本t检验、Mann-Whitney U秩和检验统计分析。采用多因素Logistic回归分析肾上腺转移瘤的危险预测因素，并采用受试者工作特征（ROC）曲线分析确定肾上腺转移瘤与良性病变鉴别诊断的最佳临界点。
    结果110个肾上腺病灶中良性病变60个，转移瘤50个，大小为0.65~5.70 cm，平均（1.65±0.82）cm。CT值-20.4~46.8 HU，平均（24.2±14.9）HU。SUVmax为1.1~31.9，平均4.5±4.6。SUVmax比值为0.44~14.5，平均1.99±2.15。单因素分析得出两者在病灶大小、CT值、SUVmax、SUVmax比值之间的差异均有统计学意义（Z=-4.908、-6.030、-7.966、-8.252，均P < 0.001）；多因素Logistic回归分析显示SUVmax比值是影响肾上腺转移瘤发生的独立因素，ROC曲线分析得出SUVmax比值=1.24为鉴别诊断肾上腺转移瘤与良性病变的最佳临界点，灵敏度和特异度分别为90.0%和93.3%。
    结论18F-FDG PET/CT显像对肾上腺转移瘤具有较高的诊断价值。SUVmax比值是肾上腺转移瘤的独立危险预测因素，鉴别诊断肾上腺良性病变与转移瘤的SUVmax比值最佳临界点为1.24。

     

    Abstract:
    ObjectiveTo discuss 18F-FDG PET/CT diagnostic value and predictive analysis in adrenal metastasis lesions.
    MethodsA total of 110 adrenal lesions in 95 non-symptom patients who underwent 18F-FDG PET/CT examination were retrospectively analyzed. Patients were divided into adrenal benign group(55 cases) and metastasis group(40 coses). Adrenal lesion size, CT attenuation value, SUVmax(standard uptake value maximum), and SUVmax ratio between adrenal and liver lesions(SUVmax ratio) were measured and recorded for each lesion. Univariate χ2 test, independent sample t-test, and Mann-Whitney U rank test were used for the statistical analyses. Univariate analysis and multivariate logistic analysis were used for the evaluation of predictive risk factor. The author performed ROC(receiver operating characteristic) curve analysis to determine the cut-off value in the diagnosis of adrenal metastasis lesions.
    ResultsA total of 110 lesions, 60 benign and 50 metastasis, were detected. The lesions diameter was 0.65 cm~5.70 cm with the average diameter (1.65±0.82) cm; the lesions CT value were -20.4~46.8 HU with the average CT value(24.2±14.9) HU; the lesions SUVmax were 1.1~31.9 with the average SUVmax 4.5±4.6; the lesions SUVmax ratio were 0.44~14.5 with the average SUVmax ratio 1.99±2.15. Differences in size, CT attenuation value, SUVmax, and SUVmax ratio between the benign and adrenal metastasis lesions were statistically significant(Z=-4.908, -6.030, -7.966, -8.252, respectively; all P < 0.001). The SUVmax ratio was the independent risk factor of adrenal metastasis. The SUVmax ratio of 1.24 was the best cutoff in the ROC analysis, yielding a sensitivity of 90.0% and specificity of 93.3%.
    Conclusions18F-FDG PET/CT is valuable in diagnosing adrenal metastasis lesions. The adrenal-to-liver SUVmax ratio is the independent risk factor of adrenal metastasis, and the SUVmax ratio of 1.24 was the best cutoff in the ROC analysis.

     

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