摘要
目的:探讨18F-FDG符合线路单光子发射型计算机断层显像(single photon emission computer tomographic,SPECT)及计算机断层显像(Computed Tomography,CT)对鉴别肺孤立性结节(solitary pulmonary nodules,SPN)为良、恶性病变的价值。方法:回顾性分析具备同期SPECT及CT影像检查并经病理确诊的SPN病例117例,将SPECT及CT的判断结果与病理结果进行比较。结果:以病理诊断恶性SPN 93例,良性SPN 24例为"金标准";SPECT诊断恶性SPN 77例,良性SPN 40例,其中,假阳性6例,假阴性22例;CT诊断恶性SPN 98例,良性SPN 19例,其中,假阳性14例,假阴性9例。SPECT检查的灵敏度、特异度、正确率、阳性预测值、阴性预测值、Youden指数为76.34%(71/93)、75.00%(18/24)、76.1%(89/117)、92.70%(71/77)、45.00%(18/40)、51.3%;CT检查的灵敏度、特异度、正确率、阳性预测值、阴性预测值、Youden指数为90.32%(84/93)、41.67%(10/24)、80.3%(94/117)、85.71%(84/98)、52.63%(10/19)、32.0%。SPECT对确诊SPN的特异度、阳性预测值、Youden指数均高于CT,差异有统计学意义(P<0.05)。结论:CT检出恶性病变的能力好于SPECT,SPECT确定良性病变的能力强于CT,总体上SPECT对SPN的确定诊断有较好的临床应用价值。
Objective: To evaluate the value of 18F-fluorodeoxyglucose(FDG) SPECT coincidence and CT imaging in diagnosis of solitary pulmonary nodules(SPN).Methods: 117 cases of patients who were confirmed SPN by pathological diagnosis were analyzed retrospectively.All cases were received SPECT coincidence and CT imaging.The results were compared with pathological results.Results: 93 patients were proved to be malignant by pathological diagnosis and 24 patients were benign.77 cases were diagnosed as cancer by 18F-FDG SPECT coincidence imaging,and 40 cases were diagnosed as benign lesions.There were 6 false positive cases and 22 false negative cases.98 cases were diagnosed as cancer by CT,and 19 cases were diagnosed as benign lesions.There were 14 false positive cases and the 9 false negative cases.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Youden index of 18F-FDG SPECT for the diagnosis of SPN were 76.34%(71/93),75.00%(18/24),76.1%(89/117),92.70%(71/77),45.00%(18/40),51.3%;The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Youden index of CT for the diagnosis of SPN were 90.32%(84/93),41.67%(10/24),80.3%(94/117),85.71%(84/98),52.63%(10/19),32.0%.The specificity,positive predictive value and Youden index of 18F-FDG SPECT were higher than CT,the differences were statistically significant(P0.05).Conclusion: The ability of 18F-FDG SPECT in confirming benign disease is more powerful than CT.Then CT is more powerful in confirming malignant than SPECT.The 18F-FDG SPECT coincidence imaging has a big value in clinical application.
出处
《中国医药导报》
CAS
2011年第29期93-95,共3页
China Medical Herald