摘要
目的 分析良恶性腹腔积液患者18 F-FDG PET/CT显像特点,探讨腹腔积液SUV对不明原因腹腔积液的辅助诊断价值.方法 回顾性分析首次18 F-FDG PET/CT检查前病因不明、但随访诊断明确的腹腔积液患者55例,其中男24例,女31例,年龄23～82(平均54.8)岁;良性腹腔积液19例,恶性腹腔积液36例.测定良恶性腹腔积液的SUV,并计算其与正常肝脏SUV的比值(T/NT).比较PET/CT肿瘤定位诊断、腹腔积液代谢判定及细胞学检查三者的诊断效能.采用两样本t检验、x2检验或确切概率法分析数据.结果 恶性腹腔积液患者18F-FDG PET/CT显像示腹腔积液代谢升高,MIP图像呈肝脾“淹没征”.恶性腹腔积液的SUVmax及SUVmax.分别为1.78±0.65和1.37±0.38,良性腹腔积液的相应值分别为1.11 ±0.36和0.72±0.22,前者明显高于后者(t=4.13、6.82,均P＜0.05).恶性腹腔积液的T/NT值明显高于良性腹腔积液(基于SUVmax的T/NT值:0.64±0.20与0.48±0.12,t=3.27;基于SUVmean.的T/NT值:0.68±0.17与0.38±0.10,t=7.21,均P＜0.05).根据腹腔积液代谢诊断恶性腹腔积液的灵敏度、特异性及准确性分别为75.0％(27/36)、94.7％(18/19)和81.8％(45/55),其灵敏度及准确性明显高于腹腔积液细胞学检查[44.4％(16/36)与63.6％(35/55);X2=6.98和4.58,均P＜0.05],其特异性明显高于PET/CT肿瘤定位诊断[63.2％ (12/19)X2=5.70,P＜0.05].结论 腹腔积液代谢升高对恶性腹腔积液的辅助诊断具有重要价值,18 F-FDG PET/CT阅片分析应密切结合腹腔积液SUV及与肝脏的T/NT值,以进一步提高对不明原因腹腔积液的良恶性鉴别诊断效率.
Objective To explore the value of SUV in patients with ascites of unknown cause.Methods A total of 55 patients (24 males,31 females,average age 54.8 years,age range:23-82 years) with ascites of unknown cause who underwent 18F-FDG PET/CT scan were retrospectively enrolled in this study.SUVmax and SUVmean of ascites and liver were measured and their ratios (T/NT) were calculated and compared by two-sample t test.All patients were followed up and had final diagnoses.Sensitivity,specifici ty,accuracy,positive predictive value and negative predictive value were calculated respectively.The diagnostic efficiency was compared among 18F-FDG PET/CT tumor localization alone,ascites radioactivity and ascites cytology examination by x2 test or Fisher exact test.Results Besides the high metabolized primary lesions and/or metastasis,the liver and spleen swamped by ascites with high radioactivity were visualized on MIP images.The SUVmax and SUVmean of malignant ascites were 1.78±0.65 and 1.37±0.38 respectively,which were higher than those of benign ascites (1.11±0.36 and 0.72±0.22; t=4.13,6.82,both P＜0.05).T/NT of malignant ascites was higher than that of benign ascites (SUVmax:0.64±0.20 vs 0.48±0.12,t =3.27,SUVmeax:0.68±0.17 vs 0.38±0.10,t =7.21 ; both P＜0.05).The diagnostic sensitivity,specificity and accuracy of SUV in ascites were 75.0％ (27/36),94.7％ (18/19) and 81.8％ (45/55),respectively.The sensitivity and accuracy of SUV were higher than those of cytological examination (44.4％ (16/36) and 63.6％ (35/55) ; x2 =6.98,4.58,both P＜0.05).The specificity of SUV was higher than that of tumor localization by 18F-FDG PET/CT (63.2％,12/19; x2 =5.70,P＜0.05).Conclusion Significantly higher SUVmax and SUV in malignant ascites than benign ascites were noted,which might play an adjuvant role in patients with ascites of unknown cause.
出处
《中华核医学与分子影像杂志》
CSCD
北大核心
2013年第6期-,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
