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目的 探讨氟脱氧葡萄糖F18正电子发射体层摄影术(18FFDGPET)在肺癌诊断及分期中的价值。方法 94例疑诊为肺部肿瘤的患者进行了CT、18FFDGPET全身或局部检查,并对这些患者手术切除及活检的组织标本及痰液、胸腔积液的细胞标本进行了病理学检查。18FFDGPET图像分析采取单纯标准摄取值(SUV)法及目测与SUV值结合两种方法进行。SUV值法判定标准为:SUV值>25为恶性病灶,SUV值≤25为良性病灶;目测与SUV值结合法:根据病灶18FFDG摄取量与纵隔血池结构相比,并考虑SUV值、病变大小、形态及病史资料做出诊断。以病理及试验性治疗结果为确诊标准,分别计算18FFDGPET及CT在病变的定性、纵隔淋巴结转移、全身远端转移方面的敏感性、特异性、准确性、阳性预测值及阴性预测值,同时对18FFDGPETSUV值法与目测结合SUV值法的诊断效能进行比较。结果 (1)确诊情况:本组58例患者肺部病灶经组织病理学或细胞病理学检查证实为恶性;36例经病理检查或试验治疗证实为良性。(2)定性诊断:CT对肺部肿块定性诊断的敏感性、特异性、准确性、阳性及阴性预测值分别为:69%、65%、68%、82%、49%;18FFDGPET单纯SUV法分别为91%、89%、90%、93%和87%,目测+SUV值法分别为95%、94%、95%、97%和92%。(3)纵隔淋巴结转移:34例病理证实有纵隔淋巴结转移
Objective To investigate the value of fluorodeoxyglucose F18 positron emission tomography (18FFDGPET) in the diagnosis and staging of lung cancer. Methods Ninety-four patients with suspected lung tumors were examined by CT or 18FFDGPET. The specimens of the resected and biopsy specimens and sputum and pleural effusion were collected for pathological examination. 18FFDGPET image analysis to take a simple standard intake value (SUV) method and visual inspection and SUV value of two methods. SUV value criteria for the determination of: SUV value> 25 for malignant lesions, SUV value ≤ 25 for benign lesions; visual and SUV value combination method: According to the 18FFDG uptake of lesions compared with the structure of the mediastinal blood pool, and consider the SUV value, lesion size , Shape and history of information to make a diagnosis. The pathological and experimental treatment results were used as the diagnostic criteria to calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 18FFDGPET and CT in the diagnosis of lesions, mediastinal lymph node metastasis and systemic distant metastasis respectively. 18FFDGPETSUV value method and visual inspection combined with SUV value of the diagnostic efficacy were compared. Results (1) Confirmed cases: The lung lesions of 58 patients in this group were proved to be malignant by histopathology or cytopathology; 36 cases were benign by pathological examination or experimental treatment. (2) Qualitative diagnosis: The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CT for the qualitative diagnosis of pulmonary masses were 69%, 65%, 68%, 82% and 49%, respectively; 18FFDGPET SUV 91%, 89%, 90%, 93% and 87% respectively, and the visual + SUV values were 95%, 94%, 95%, 97% and 92% respectively. (3) mediastinal lymph node metastasis: 34 cases of pathologically confirmed mediastinal lymph node metastasis