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目的:评价n 18F-脱氧葡萄糖(FDG)PET/CT显像对心脏良恶性肿瘤鉴别诊断的价值。n 方法:自2015年1月至2018年9月于北京安贞医院行n 18F-FDG PET/CT全身显像的3 678例受检者中，心脏占位性病变患者共51例(1.39%)。将28例有病理诊断的心脏占位性病变患者纳入研究，其中男10例，女18例；年龄：18～84 (52±14)岁。依据病理结果将患者分为原发良性组(组1，n n＝9)，原发恶性组(组2，n n＝9)，淋巴瘤组(组3，n n＝6)，继发恶性组(组4，n n＝4)。患者均行早期(1 h) n 18F-FDG PET/CT显像，其中22例患者(组1、2、3、4分别有6、7、6、3例)行延迟(2 h)显像，采用单因素方差分析和Scheffe检验比较4组间病灶最大标准摄取值(SUVn max)和病灶/本底比值(TBR)差异，TBR＝SUVn max/肝平均标准摄取值(SUVn mean)；另行受试者工作特征(ROC)曲线分析。n 结果:组1、2、3、4早期显像SUVn max[SUVn max(early)]分别为2.6±1.5、9.9±4.0、20.5±6.1、9.2±5.8 (n F＝21.39, n P<0.01)，其中组1低于组2和组3，组3最高(均n P<0.005)；4组早期显像TBR(TBRn early)分别为1.1±0.6、4.1±1.6、9.4±2.6、3.7±2.0 (n F＝29.15, n P<0.01)，其中组1低于组2和组3，组3最高(均n P<0.005)。4组延迟显像SUVn max [SUVn max(delay)]分别为2.4±1.2、11.0±5.9、25.8±7.7、13.7±7.7 (n F＝16.01, n P<0.01)，延迟显像TBR(TBRn delay)分别为1.3±0.7、5.5±2.9、14.4±4.9、7.9±5.0(n F＝14.78, n P<0.01)，其中组3均高于组1和组2(均n P<0.005)。ROC曲线鉴别心脏肿瘤良恶性的最佳界值如下：SUVn max(early)＝4.2、TBRn early＝1.6，SUVn max(delay)＝4.6、TBRn delay＝1.9，各界值对应的诊断心脏恶性肿瘤灵敏度、特异性和准确性分别为19/19、8/9、96.4%(27/28)；19/19、7/9、92.9%(26/28)；16/16、6/6、100%(22/22)；16/16、5/6、95.5%(21/22)。n 结论:18F-FDG PET/CT显像能较为准确地诊断心脏恶性肿瘤，而延迟显像能进一步提高诊断的准确性。n “,”Objective:To evaluate the clinical value of n 18F-fluorodexoyglucose (FDG) PET/CT in distinguishing benign from malignant tumors in patients with cardiac tumors.n Methods:Between January 2015 and September 2018, n 18F-FDG PET/CT was performed in 3 678 patents in Beijing Anzhen Hospital, and 51 of them (51/3 678, 1.39%) were diagnosed as cardiac tumors. Finally, 28 patients (10 males, 18 females; mean age (52±14) years, age range: 18-84 years) with pathological results were included. According to pathological results, patients were divided into 4 groups: group 1 with primary benign cardiac tumor (n n=9), group 2 with primary malignant cardiac tumor (n n=9), group 3 with lymphoma (n n=6) and group 4 with secondary malignant cardiac tumor (n n=4). All patients underwent early (60 min) n 18F-FDG PET/CT imaging and 22 patients (6, 7, 6, 3 patients in group 1, group 2, group 3, group 4 respectively) underwent delayed (120 min) imaging. The maximum standardized uptake value (SUVn max) and target/backgroud ratio (TBR) of 4 groups in early imaging and delayed imaging were calculated and compared with one-way analysis of viariace and Scheffe Post-hoc test. TBR were calcualted as SUVn max/mean standardized uptake value (SUVn mean) in the liver. Receiver operating characteristic (ROC) curve analysis was also performed.n Results:SUVn max during early imaging, defined SUVn max(early), was 2.6±1.5, 9.9±4.0, 20.5±6.1, 9.2±5.8 in group 1-4 respectively (n F=21.39, n P<0.01), the value of group 1 was lower than that of group 2 and 3, and the value of group 3 was the highest (alln P<0.005). TBRn early was 1.1±0.6, 4.1±1.6, 9.4±2.6, 3.7±2.0 in the 4 groups (n F=29.15, n P<0.01), the value of group 1 was lower than that of group 2 and 3, and the value of group 3 was the highest (alln P<0.005). SUVn max in delayed imaging (SUVn max(delay)) was 2.4±1.2, 11.0±5.9, 25.8±7.7, 13.7±7.7 respectively in the 4 groups (n F=16.01, n P<0.01). TBRn delay was also significantly different among the 4 groups (1.3±0.7, 5.5±2.9, 14.4±4.9, 7.9±5.0; n F=14.78, n P<0.01), the value of group 3 was higher than that of group 1 and 2 (alln P<0.05). ROC curve analysis showed optimal cut-off values for indicating malignancy were: SUVn max(early)=4.2, TBRn early=1.6, SUVn max(delay)=4.6, TBRn delay=1.9. The corresponding sensitivities, specificities, accuracies were 19/19, 8/9, 96.4%(27/28); 19/19, 7/9, 92.9%(26/28); 16/16, 6/6, 100%(22/22); 16/16, 5/6, 95.5%(21/22), respectively.n Conclusions:18F-FDG PET/CT imaging can accurately diagnose malignant cardiac tumors. Delayed imaging can further improve the accuracy for diagnosis of malignant cardiac tumors.n