摘要
目的探讨^(18)F-脱氧葡萄糖(^(18)F-FDG)符合线路单光子发射计算机断层显像(SPECT/CT)在肺内结节诊断中的应用价值。方法回顾性分析行肺CT和SPECT/CT检查并经病理或随访确诊的128例肺结节患者,用半定量法(计算病灶组织与周围软组织的摄取比值T/N)测量,所得数据进行统计学分析。比较所有患者CT检查结果以及SPECT/CT检查,统计其敏感度、特异度、阳性预测值、阴性预测值以及准确性,比较良恶性肿瘤患者SPECT/CT诊断结果的T/N值。结果肺部结节良恶性SPECT/CT诊断灵敏度、特异度、阴性预测值、阳性预测值、准确性分别为96.46%、86.67%、76.51%、98.13%、95.32%,经过配对优势卡方检验发现,与病理诊断结果无显著差异(χ~2=0.25,P=0.617)。肺部结节良恶性CT诊断灵敏度、特异度、阴性预测值、阳性预测值、准确性分别为86.72%、73.33%、86.08%、42.3%、85.1%,经过配对优势卡方检验发现,与病理诊断结果差异显著(χ~2=5.26,P=0.022)。SPECT/CT与CT两种诊断方法诊断灵敏度、特异度、阴性预测值、阳性预测值、准确性差异显著,SPECT/CT诊断明显优于单纯CT诊断,差异具有统计学意义(P<0.05)。经秩和检验,良恶性肿瘤患者结节T/N比值在<2、2~3、>3等区间的人数差异显著(u=2.87,P=0.012),且恶性组患者结节T/N平均值为2.98±0.6,明显大于良性组的1.23±0.2,差异具有统计学意义(P<0.05)。结论^(18)F-FDG符合线路SPECT/CT显像对肺内结节的诊断具有较高的特异性和敏感性,可以有效提高肺内结节的诊断准确度。
Objective To discuss the clinical application of ^18F fluorodeoxyglucose（^18F-FDG） coincidence single photon emission computed tomography（SPECT/CT） in the diagnosis of lung nodules.Methods The CT and SPECT/CT findings of 128 cases with pulmonary nodules were collected.Semi quantitative measurement method（uptake ratio of tumor tissues to periodic soft tissue,T/N） were used.The data were statistically analyzed.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CT and SPECT/CT were calculated,and the results of SPECT/CT in the diagnosis of benign and malignant tumors were analyzed.Results The sensitivity,specificity and negative predictive value,positive predictive value and accuracy of SPECT/CT in the diagnosis of lung nodules were 96.46%,86.67% and76.51%,98.13%,95.32%,and with no significant difference with pathological results（χ^2= 0.25,P=0.617）.The sensitivity,specificity and negative forecast value,positive predictive value and accuracy of CT were 86.72% and 73.33%,86.08%,42.3%,85.1% with significant difference with pathological results（χ^2= 5.26,P=0.022）.The sensitivity,specificity,negative predictive value,positive predictive value and accuracy of SPECT/CT were higher than those of CT with significant difference（P〈0.05）.The T/N ratio of patients with benign and malignant nodules was significantly different in〈2,2 ~ 3,〉3（u=2.87,P=0.012）.The average T/N value of malignant group（2.98 ± 0.6） was significantly higher than that of the benign group（1.23 ± 0.2）,the difference was statistically significant（P〈0.05）.Conclusion The specificity and sensitivity of ^18F-FDG SPECT/CT imaging in the diagnosis of pulmonary nodules were high,and this examination can effectively improve the diagnostic accuracy of pulmonary nodules.
出处
《临床和实验医学杂志》
2017年第7期662-665,共4页
Journal of Clinical and Experimental Medicine
基金
航天中心医院科研基金资助项目(编号201114)
