摘要
目的 比较恶性胸腔积液与结核性胸腔积液的^18F-FDG PET/CT显像特征.方法 回顾性分析2012年1月至2014年12月间93例[男52例,女41例;年龄（66.7± 12.7）岁]因不明原因胸腔积液行^18F-FDG PET/CT显像且通过组织学、细胞学和临床随访最终诊断为恶性胸腔积液和结核性胸腔积液的患者资料.半定量分析病变SUVmax和T/NT,目测法定性分析^18F-FDG摄取分布形态特点,测量病变大小和CT值.对比分析两者^18F-FDG PET/CT显像差别,并计算^18F-FDG PET/CT显像对两者的诊断效能.采用两样本t检验和χ^2检验分析数据.结果 结核性胸腔积液27例,恶性胸腔积液66例.两者SUVmax均高于正常组织（8.43±4.92,7.72±6.50;t=7.15和7.81,均P＜0.01）,但两者间差异无统计学意义（t=0.56,P＞0.05）;两者T/NT分别为5.20±2.73和5.40±4.29（t=-0.22,P＞0.05）.两者摄取形态分布差异有统计学意义（χ^2=29.3,P＜0.01）.以胸膜病变^18F-FDG摄取结节状增高视作恶性、弥漫性增高视作结核,^18 F-FDG PET/CT显像的灵敏度为78.8％ （52/66）,特异性为81.5％ （22/27）,阳性预测值为91.2％（52/57）,阴性预测值为61.1％ （22/36）.PET显像发现原发癌灶43例,未发现原发灶23例.以胸膜病变^18F-FDG摄取结节状增高或PET显像发现原发癌伴胸膜摄取增高,即视作恶性胸腔积液,^18F-FDG PET/CT显像的上述指标分别为95.5％ （63/66）、81.5％（22/27）、92.6％（63/68）和88.0％（22/25）.结论 恶性胸腔积液和结核性胸腔积液^18F-FDG摄取均高于正常组织;PET/CT显像有助于恶性胸腔积液原发灶的寻找;^18F-FDG PET/CT显像定性方法对恶性胸腔积液和结核性胸腔积液具有较好的鉴别诊断价值.
Objective To compare the imaging features of ^18F-FDG PET/CT in malignant pleural effusion （MPE） and tuberculosis pleural effusion （TPE）.Methods From January 2012 to December 2014,93 patients （52 males,41 females,and average age （66.7±12.7） years） with unexplained pleural effusion who underwent ^18F-FDG PET/CT were retrospectively studied.MPE and TPE were confirmed by histology,cytology or clinical follow-up.Lesion SUVmax and T/NT were calculated.Both lesion size and density （in Hounsfield units） of pleural abnormalities on CT images were measured.The difference of images between MPE and TPE was analyzed.Diagnostic efficiency of ^18F-FDG PET/CT for detecting MPE and TPE were estimated.Two-sample t test and χ^2 test were used to analyze the data.Results The lesion SUVmax of 66 patients with MPE and 27 patients with TPE was higher than that in normal tissues （7.72±6.50,8.43±4.92;t=7.81 and 7.15,both P〈0.01）,but there was no statistical difference between the TPE and MPE （t=0.56,P〉0.05）.T/NT was not significantly different between MPE and TPE （5.40±4.29,5.20±2.73 respectively,t=-0.22,P〉0.05） either.The uptake features of ^18F-FDG were different between MPE and TPE （χ^2=29.3,P〈0.01）.When the nodular ^18F-FDG uptake increase in pleura was taken as the malignancy,diffuse ^18F-FDG uptake increase in pleura as tuberculosis,the sensitivity,specificity,positive predictive value,and negative predictive value of ^18F-FDG PET/CT were 78.8% （52/66）,81.5% （22/27）,91.2% （52/57）,61.1% （22/36）,respectively,for differentiation of MPE from TPE.Primary cancers were found in 43 patients.When the nodular uptake increase in pleura,or primary cancer associated with increased pleural uptake found by PET was taken as the malignancy,the above mentioned parameters were95.5%（63/66）,81.5%（22/27）,92.6%（63/68）,88.0%（22/25）,respectively.Conclusions The ^18FFDG uptake in MPE and TPE is higher than that in normal tissues.^18F-FDG PET/CT is helpful in the search for the primary tumor of MPE.Qualitative method of ^18F-FDG PET/CT has a good value in the differentiation of MPE from TPE.
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2016年第3期206-210,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
国家自然科学基金（81301249）
