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目的探讨~(18)F-脱氧葡萄糖(fluorine-18fluorodeoxyglucose,~(18)F-FDG)符合线路显像对胸腔积液病因及性质鉴别诊断的价值。方法 48例胸腔积液患者,经X线片、CT或MRI检查及胸腔积液常规生化检查等未明确病因而行~(18)F-FDG符合线路显像,与组织病理结果进行对照,分析~(18)F-FDG符合线路显像的诊断效能。结果 48例中组织病理结果证实恶性肿瘤33例,良性疾病15例;33例恶性肿瘤患者中恶性胸腔积液26例、良性胸腔积液7例,良性疾病患者胸腔积液均为良性;与组织病理结果对照,33例恶性肿瘤者中~(18)F-FDG符合线路显像准确诊断29例,2例肺腺癌及1例多发性骨髓瘤、1例卵巢癌胸膜转移误诊为良性;15例良性疾病者中~(18)F-FDG符合线路显像准确诊断12例,胸膜炎和胸膜结核各1例被误诊为胸膜间皮瘤,1例肺肉芽肿性炎伴胸膜炎误诊为肺癌并胸膜转移;26例恶性胸腔积液中,18 F-FDG符合线路准确诊断23例,2例肺腺癌及1例卵巢浆液性腺癌胸膜转移未被检出;22例良性胸腔积液中,2例胸膜炎及1例胸膜结核被误诊为恶性胸腔积液;~(18)F-FDG符合线路显像诊断恶性肿瘤的敏感度为87.88%、特异性为80.00%、准确性为85.42%、阳性预测值为90.63%、阴性预测值为70.58%;诊断恶性胸腔积液的灵敏度为88.46%、特异性为86.36%、准确性为87.50%、阳性预测值为88.46%、阴性预测值为86.36%。结论 ~(18)F-FDG符合线路显像在不明原因胸腔积液患者原发病的诊断、胸腔积液良、恶性的鉴别诊断中具有较高价值。
Objective To investigate the diagnostic value of 18F-FDG (18F-FDG) coincidence imaging in the differential diagnosis of pleural effusion. Methods Forty-eight patients with pleural effusion underwent eighteen F-FDG coincidence imaging without X-ray, CT or MRI examination and routine biochemical examination of pleural effusion, and compared with histopathological findings ~ (18) F-FDG line diagnostic imaging performance. Results Totally 33 malignant tumors and 15 benign diseases were confirmed by histopathology in 48 cases. Among 33 patients with malignant tumors, 26 were malignant pleural effusions and 7 were benign pleural effusions. Pleural effusion was benign in benign diseases. The pathological results of control, 33 cases of malignant tumor in 18 F-FDG coincidence line imaging accurate diagnosis of 29 cases, 2 cases of lung adenocarcinoma and 1 case of multiple myeloma, 1 case of ovarian cancer misdiagnosed as benign pleural metastasis; 15 Cases of benign disease in 18 F-FDG coincidence line imaging accurate diagnosis of 12 cases, 1 case of pleurisy and pleural tuberculosis were misdiagnosed as pleural mesothelioma, 1 case of pulmonary granulomatous inflammation associated with pleurisy misdiagnosed as lung cancer and pleural In 26 malignant pleural effusions, 23 cases were correctly diagnosed by 18 F-FDG coincidence, 2 cases of lung adenocarcinoma and 1 case of ovarian serous adenocarcinoma were not detected. In 22 cases of benign pleural effusion, 2 cases Pleurisy and 1 case of pleural tuberculosis were misdiagnosed as malignant pleural effusion. The sensitivity of ~ (18) F-FDG coincidence imaging was 87.88%, the specificity was 80.00% and the accuracy was 85.42%. The positive predictive value Was 90.63%, negative predictive value was 70.58%; the sensitivity of diagnosis of malignant pleural effusion was 88.46% Heterosexual 86.36% and accuracy was 87.50%, 88.46% positive predictive value, negative predictive value of 86.36%. Conclusions ~ (18) F-FDG coincidence imaging in the diagnosis of pleural effusion in patients with unexplained pleural effusion, benign and malignant pleural effusion has high value in the differential diagnosis.